Strategic Medicaid Provider Compliance Lead

CVS Health Corporation; Lansing (MI); Presencial; USD 33.000 - 159.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Descripción de la vacante

CVS Health Corporation is seeking a strategic Manager, Medicaid Provider Compliance to lead enterprise-wide provider compliance, audit readiness, and regulatory initiatives across the organization. You will partner with executive leadership, compliance, legal, provider operations, and external auditors to identify risks and drive sustainable improvements.

The role emphasizes translating regulatory requirements into practical solutions, building controls, data integrity, and enterprise risk

Formación

• 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.

Responsabilidades

• Drive enterprise priorities, manages risk, and translates regulatory requirements into business solutions.
• Lead development and execution of compliance strategies aligning with contractual, regulatory, and business objectives.
• Serve as SME for provider compliance and audit readiness, improving data integrity and internal controls.
• Use data and compliance expertise to optimize processes and deliver sustainable results.
• Build partnerships with senior leaders and influence outcomes across functions.
• Lead provider compliance, audit preparedness, and regulatory initiatives across the organization.
• Develop audit response and remediation strategies addressing root causes and long-term improvements.
• Communicate audit outcomes and compliance risks to executive leadership.

Conocimientos

Advanced Excel

Data analysis

Stakeholder influence

Educación

Bachelor's degree or equivalent work experience

Herramientas

Regulatory reporting tools

Descripción del empleo

CVS Health Corporation is seeking a strategic Manager, Medicaid Provider Compliance to lead enterprise-wide provider compliance, audit readiness, and regulatory initiatives across the organization. You will partner with executive leadership, compliance, legal, provider operations, and external auditors to identify risks and drive sustainable improvements.

The role emphasizes translating regulatory requirements into practical solutions, building controls, data integrity, and enterprise risk