Remote Senior Manager, Medicaid Compliance

CVS Health Corporation; Southfield, Northern (MI, KY); Hybrid; USD 75,000 - 166,000; Full time

Job summary

CVS Health is seeking a Senior Manager of Medicaid Compliance to oversee the compliance program for the Michigan Medicaid health plan. In this role you will act as the Compliance Officer and lead a team, ensuring timely regulatory submissions and adherence to contract and state requirements across the MI market.

You will collaborate with state agencies, prepare audits, craft policy guidance, and train staff on compliance processes, controls, and risk mitigation.

Qualifications

• 7+ years of regulatory compliance experience in managed care, health care, or insurance.
• 2+ years of project management experience.
• Experience with Medicaid or Medicaid managed care preferred.
• Bachelor’s Degree required; Master’s or JD preferred.

Responsibilities

• Manage and oversee the Medicaid compliance program for the MI health plan.
• Prepare regulatory reports and coordinate with state Medicaid agencies.
• Lead external audits and corrective action plans with health plan leadership.
• Provide training and guidance to staff on compliance processes and controls.

Skills

Regulatory compliance

Project management

Medicaid experience

Education

Bachelor's Degree

Master’s degree

Juris Doctor (JD)

Tools

Archer

Microsoft Office

Job description

CVS Health is seeking a Senior Manager of Medicaid Compliance to oversee the compliance program for the Michigan Medicaid health plan. In this role you will act as the Compliance Officer and lead a team, ensuring timely regulatory submissions and adherence to contract and state requirements across the MI market.

You will collaborate with state agencies, prepare audits, craft policy guidance, and train staff on compliance processes, controls, and risk mitigation.