CVS Health
CVS Health
CVS Health is an American healthcare company working across healthcare services, health insurance, pharmacy benefits management, and retail pharmacy. Through businesses including Aetna and CVS Caremark, it supports health coverage, prescription access, condition management, specialty medications, and mail-order pharmacy services. Its neighborhood pharmacies and broader care offerings are designed to help people access essential healthcare more conveniently and affordably. CVS Health brings together insurance, pharmacy, and health services to support individuals and communities throughout their care journeys.

Medicaid Compliance Analyst

Support CVS Health’s managed care compliance program by tracking regulatory deliverables, audits, risk mitigation, and state Medicaid obligations.

Description

  • Track and submit regulatory and compliance deliverables to state Medicaid agencies using monitoring systems and tools.
  • Prepare routine regulatory reports for the Medicaid compliance team.
  • Research state Medicaid rules and recommend compliant business practices, processes, and policies.
  • Draft compliance communications in response to state Medicaid agency inquiries and requests.
  • Stay current on contractual, regulatory, and program policy obligations.
  • Advise health plan and growth partner staff to support education and business decisions.
  • Coordinate external audit support, including project management, deliverable tracking, responses, and corrective action plans through resolution.
  • Maintain contract libraries, reporting assignments, risk assessments and trackers, internal reporting systems, and department tools.
  • Use Microsoft applications, Archer, and other role-specific systems; maintain documentation, train users, and support system design, oversight, and maintenance.
  • Assist with compliance oversight and monitoring across the business.
  • Help develop and carry out mitigation and corrective action plans, escalating risks and issues through appropriate channels.
  • Build and maintain constructive relationships with internal and external stakeholders.
  • Carry out other duties as assigned.

Requirements

  • At least two years of regulatory compliance experience in managed care, healthcare, or insurance, or a master’s degree.
  • Bachelor’s degree.
  • Medicaid or Medicaid managed care experience preferred.
  • Project management experience preferred.
  • Audit experience preferred.
  • Proficiency with Microsoft products and compliance tools such as Archer.
  • Ability to work with the contractual, regulatory, and program policy obligations of Medicaid managed care organizations.

Benefits

  • Eligibility for a CVS Health bonus, commission, or short-term incentive program in addition to the base pay range.
  • Medical coverage.
  • Dental coverage.
  • Vision coverage.
  • Paid time off.
  • Retirement savings options.
  • Wellness programs.
  • Resources supporting physical, emotional, and financial well-being.

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