Senior Medicaid Compliance & Audit Leader

CVS Health Corporation; Nashville (TN); On-site; USD 54,000 - 159,000; Full time

Benefits offered by this job

Bonus eligible

Comprehensive benefits

Job summary

CVS Health Corporation in Nashville seeks a strategic Manager, Medicaid Provider Compliance to drive Medicaid provider compliance, audit readiness, regulatory integrity, and enterprise risk management across the organization.

You will serve as a senior subject matter expert responsible for shaping compliance strategy, leading cross-functional initiatives, and delivering sustainable solutions that strengthen regulatory performance and operational excellence.

Qualifications

• 7+ years of healthcare compliance, audit, or provider operations experience.
• Strong analytical, risk assessment, and problem-solving skills.
• Excellent communication and stakeholder influence skills.

Responsibilities

• Drive enterprise priorities, manages risk, and translates regulatory requirements into business solutions.
• Leads the development and execution of compliance strategies that support contractual, regulatory, and business objectives while promoting a culture of accountability, continuous improvement, and risk awareness.
• Serves as a subject matter expert for provider compliance and audit readiness, driving initiatives that improve data integrity, strengthen internal controls, standardize processes, and enhance organizational performance.
• Develop and execute audit response and remediation strategies addressing root causes and long-term compliance improvements.
• Lead complex, high-visibility projects spanning multiple departments with governance, accountability, risk management, and execution.

Skills

Leadership

Data analysis

Risk assessment

Communication

Problem-solving

Regulatory knowledge

Education

Bachelor’s degree or equivalent

Master’s degree preferred

Tools

Excel

Job description

CVS Health Corporation in Nashville seeks a strategic Manager, Medicaid Provider Compliance to drive Medicaid provider compliance, audit readiness, regulatory integrity, and enterprise risk management across the organization.

You will serve as a senior subject matter expert responsible for shaping compliance strategy, leading cross-functional initiatives, and delivering sustainable solutions that strengthen regulatory performance and operational excellence.