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Position Summary
Seniorlevel compliance position thatis responsible for the management, execution, and oversightof thecompliance program activities and deliverables of a Medicaid managed care organizationoperating in a highly complex regulatory environment.Oversees the activities of other compliance team membersassigned to the market.This positionis responsiblefor developingand maintainingsystems and processes that demonstrate the principles of an effective Compliance program and promote compliant and ethical behavior inthe assignedMedicaid health plan. Responsibilities include, but are not limited to:
Maintain an in-depth working knowledge of the health plan’s contractual, regulatory, and program policy related obligations as a Medicaid managed care organization and serve as a resource to health plan and growth partner staff for education, training,and business decision making purposes.
Ensurethat currentresource tools and other internal deliverables such as current contract library, regulatory reporting assignments,risk assessments, risk tracking lists, internal reporting systems and summaries, and other department wide toolsare current and accessible to business partnersto ensure the appropriate monitoring and oversight of health plan compliance processes.
Utilize systems unique to job functions, including standard-issue software such as Microsoft productsand compliance specific tools such as Archer; maintain system documentation, serve as subject matter expert, train users of system, contribute to system design, oversight or maintenance.
Lead and directoversight and monitoringactivitiesto evaluate levels of compliance withnew and existingMedicaid managed care organization requirementsacross the business; support business partners in the development of mitigation and corrective action plans and effectively escalate risks, concerns and other issues through appropriate channels.
Oversee the submission of required regulatory reports(standard and ad hoc), includingthe completion of high level quality reviews prior to submission andthemaintenance of tracking systems and tools todocument ownership, reporting requirements, andmonitor timely delivery and acceptance of reports.
• 10+ years of previous experience in Medicaid or Medicaid managed care.
• 5+ years of roles that required use of project management skills and responsibilities.
• 2+ years of previous management experience.
Bachelors degree required or equivalent years of related experience.
Pay Range
The typical pay range for this role is:
$100,000.00 - $231,540.00
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. This position also includes an award target in the company’s equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 08/17/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
