Senior Analyst, National Medicaid Business Compliance

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

The Corporate Medicaid Business Compliance Office (BCO) Team is seeking a highly organized and detail-oriented Senior Analyst to support the Medicaid Contract Amendment (MCA) Program. This role supports the identification, assessment, compliance oversight, and tracking of new and amended Medicaid contractual requirements across Medicaid health plans.

The ideal candidate has knowledge of Medicaid managed care and compliance processes, with experience supporting state contract requirements, compliance operations, systems, and cross-functional workflows. They possess strong analytical and organizational skills and have experience coordinating activities between stakeholders and competing priorities.

The Sr. Analyst supports multiple market-specific amendments through maintenance of compliance portfolios and requirement trackers, documentation of contractual changes, support of compliance-related communications and activities, and organization of documentation and evidence. This role will also assist with issue identification, process improvement efforts, and additional departmental initiatives as needed.

• Support compliance activities related to new and revised Medicaid contractual and regulatory requirements.

• Review, compare, and document contractual requirement changes to support compliance oversight and tracking activities.

• Maintain compliance portfolios, requirement trackers, and supporting documentation associated with Medicaid contract amendments

• Coordinate with Compliance and business partners through recurring and ad hoc touch points to facilitate communication, monitor progress, and address questions.

• Support amendment intake, communications, and processes through centralized controls and tools.

• Monitor amendment-related compliance activities and support the collection and maintenance of compliance documentation and evidence.

To be successful in this role you must exhibit the following:

• Ability to work independently with minimal guidance while managing multiple priorities.

• Strong analytical skills with experience reviewing, comparing, and documenting complex information.

• Experience building relationships and collaborating across teams.

• Strong skills in organizing, prioritizing, and managing multiple concurrent assignments and deadlines.

• Strong attention to detail and experience maintaining accurate documentation and reporting.

• Excellent written, verbal, and interpersonal communication skills.

• Proficiency in Microsoft Office applications, including Word, Excel, and PowerPoint.

• Proficiency with SharePoint, Microsoft Teams, and other collaboration and document management tools.

In order to be successful in this role you must exhibit the following:

• Experience supporting complex cross-functional initiatives, compliance activities, or operational programs.

• Strong analytical, organizational, interpersonal, and communication skills.

• Ability to work independently, identify issues, and escalate concerns appropriately.

• 3+ years of Compliance experience and/or Medicaid Managed care experience.

• 3+ years of experience using Microsoft Office applications, including Word, Excel, and PowerPoint.

• Experience conducting contractual or policy research.

• Knowledge of state and federal healthcare laws and regulations, particularly within Medicaid managed care.

• Familiarity with Governance, Risk, and Compliance (GRC) tools and compliance tracking systems.

• Ability to analyze issues and develop practical solutions.

• Bachelor's degree required or equivalent years of related experience.

The typical pay range for this role is:

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. 
 

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