Medicaid Provider Compliance Lead | Audit Excellence

CVS Health; Nashville (TN); On-site; USD 47,000 - 112,000; Full time

Job summary

CVS Health seeks a dynamic leader to drive Medicaid provider compliance, audit excellence, and regulatory integrity. You will lead strategic initiatives to ensure timely, high-quality audit results, strengthen regulatory relationships, and mitigate risk through proactive measures.

This role partners cross-functionally to optimize processes and data integrity. The candidate will deliver compliant, efficient operations, mentor teams, and manage multiple projects toward strategic goals in a

Qualifications

• 3+ years progressive experience in audit, compliance, or related healthcare operations.
• Strong ability to develop and execute detailed project plans with accountability and rigor.
• Analytical skills to interpret data, identify trends, and propose actionable solutions.

Responsibilities

• Direct collaboration with internal teams and external auditors to deliver quality results and ensure compliance.
• Interpret audit findings and recommend corrective actions and process improvements.
• Support responses to complex inquiries from internal stakeholders and regulators with accuracy and timeliness.
• Serve as a technical and functional leader, managing multiple compliance-related projects.
• Oversee policy/procedural documentation and annual reviews.

Skills

Audit management

Compliance

Data analysis

Excel (Advanced)

Communication

Project leadership

Education

Bachelor's degree

Tools

Microsoft Excel

Job description

CVS Health seeks a dynamic leader to drive Medicaid provider compliance, audit excellence, and regulatory integrity. You will lead strategic initiatives to ensure timely, high-quality audit results, strengthen regulatory relationships, and mitigate risk through proactive measures.

This role partners cross-functionally to optimize processes and data integrity. The candidate will deliver compliant, efficient operations, mentor teams, and manage multiple projects toward strategic goals in a