Medicaid Provider Compliance Leader

CVS Health Corporation; Baton Rouge (LA); Vor Ort; USD 54.000 - 159.000; Vollzeit

Benefits dieser Stelle

Comprehensive benefits package

Bonus eligibility

Zusammenfassung

CVS Health Corporation is seeking a strategic Manager, Medicaid Provider Compliance to drive compliance strategy, audits, and enterprise risk management across the organization. You will serve as a senior SME shaping initiatives, influencing business decisions, and delivering sustainable regulatory performance.

You will lead complex cross-functional projects, monitor controls, and partner with regulators, auditors, and health plans to strengthen compliance and operational excellence.

Qualifikationen

• 7+ years of healthcare compliance, audit, or provider operations experience.
• Proven ability to lead complex projects and compliance initiatives.
• Experience managing audits, CAPs, and regulatory responses.
• Strong analytical, risk assessment, and problem-solving skills.
• Knowledge of Medicaid regulations and provider compliance requirements.
• Excellent communication and stakeholder influence skills.
• Ability to drive results across teams and manage competing priorities.
• Advanced Excel and data analysis proficiency.

Aufgaben

• Drive enterprise priorities, translates regulatory requirements into business solutions.
• Lead development and execution of compliance strategies supporting contractual and regulatory objectives.
• Serve as a subject matter expert for provider compliance and audit readiness across the organization.
• Use data and compliance expertise to optimize processes, strengthen controls, and deliver sustainable results.
• Build trusted partnerships and communicate with senior leaders to influence outcomes.
• Lead enterprise-wide provider compliance, audit preparedness, and regulatory initiatives.
• Provide strategic guidance to leadership on complex provider compliance matters.
• Develop audit response and remediation strategies addressing root causes.
• Influence cross-functional stakeholders to align priorities and implement effective solutions.
• Assess emerging regulatory requirements and business risks to ensure compliance and readiness.

Kenntnisse

Regulatory compliance

Audits & CAPs

Data analysis

Risk assessment

Communication

Stakeholder influence

Cross-functional leadership

Advanced Excel

Ausbildung

Bachelor's degree or equivalent

Jobbeschreibung

CVS Health Corporation is seeking a strategic Manager, Medicaid Provider Compliance to drive compliance strategy, audits, and enterprise risk management across the organization. You will serve as a senior SME shaping initiatives, influencing business decisions, and delivering sustainable regulatory performance.

You will lead complex cross-functional projects, monitor controls, and partner with regulators, auditors, and health plans to strengthen compliance and operational excellence.