CVS Health
CVS Health
CVS Health — денсаулық сақтау қызметтері, медициналық сақтандыру, дәріхана жәрдемақыларын басқару және бөлшек дәріхана салаларында жұмыс істейтін америкалық денсаулық сақтау компаниясы. Aetna және CVS Caremark сияқты бизнес бағыттары арқылы медициналық сақтандыруды, рецепт бойынша дәрілерге қолжетімділікті, ауруларды басқаруды, арнайы дәрілерді және пошта арқылы дәріхана қызметтерін ұсынады. Оның жергілікті дәріханалары мен кең ауқымды медициналық қызметтері адамдарға негізгі медициналық көмекті ыңғайлырақ әрі қолжетімді бағамен алуға көмектесуге бағытталған. CVS Health сақтандыру, дәріхана және денсаулық сақтау қызметтерін біріктіріп, адамдар мен қауымдастықтарға емделу жолының барлық кезеңінде қолдау көрсетеді.

Medicaid Compliance Analyst

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

Сипаттама

  • 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.

Талаптар

  • 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.

Артықшылықтар

  • 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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