Medicaid Provider Compliance Leader
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. We are seeking a dynamic leader to drive Medicaid provider compliance, audit excellence, and regulatory integrity across our organization. In this role, you will lead strategic initiatives that ensure accurate, timely, and high-quality audit results, strengthen regulatory relationships, and implement proactive measures to mitigate risk. You'll partner cross-functionally to optimize audit results and implement preventative measures to mitigate risk, while influencing best practices that enhance operational efficiency and compliance.
If you are a proactive problem solver with strong leadership skills and a passion for delivering sustainable, compliant solutions, we want to hear from you.
Position Summary
Leads and ensures the delivery of high-quality internal and external Medicaid provider audit results, regulatory compliance activities, and proactive risk mitigation strategies. Applies deep expertise in compliance, business operations, analytics, and communication to develop and execute strategies that support regulatory and contractual obligations. Partners cross-functionally to support accurate, complete, and timely audit and regulatory deliverables, standardize processes, optimize workflows, and enable data integrity across the organization. Drives and supports provider compliance initiatives that promote consistency, accuracy, compliance, and operational excellence.
The ideal candidate is a strategic, solutions-oriented leader with strong analytical and communication skills, capable of influencing outcomes and implementing best practices that enhance audit performance, regulatory relationships, and operational efficiency. This role requires technical acumen, critical thinking, and the ability to lead complex initiatives in a dynamic environment.
Key Responsibilities
Required Qualifications
Preferred Qualifications
Education
Bachelor's degree preferred / specialized training / relevant professional qualification.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is : $46,988.00 - $122,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Great Benefits for Great People
We take pride in our comprehensive and competitive mix of pay and benefits investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include :
For more information, visit https : / / jobs.cvshealth.com / us / en / benefits
We anticipate the application window for this opening will close on : 01 / 03 / 2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex / gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
Senior Compliance Analyst • Atlanta, GA, US