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The position is described below. If you want to apply, click the Apply Now button at the top or bottom of this page. After you click Apply Now and complete your application, you'll be invited to create a profile, which w…
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Washington, District of Columbia, United States · On-site
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The role involves leading enterprise-wide Medicaid provider compliance, audit readiness, and regulatory oversight to ensure operational excellence. You will partner with cross-functional stakeholders to develop mitigation strategies, manage compliance risks, and drive continuous improvement initiatives.
Candidates must have at least 7 years of experience in healthcare compliance, audit, or provider operations. A bachelor's degree is required, with a preference for a master's degree in a related field.
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.
We are seeking a strategic compliance leader to drive Medicaid provider compliance, audit readiness, regulatory integrity, and enterprise risk management across the organization. This role serves as a senior subject matter expert responsible for shaping compliance strategy, leading complex cross-functional initiatives, influencing business decisions, and advancing sustainable solutions that strengthen regulatory performance and operational excellence. The successful candidate will partner with executive leadership, health plan stakeholders, compliance, legal, provider operations, and external auditors to proactively identify compliance risks, develop enterprise-wide mitigation strategies, and establish best-in-class audit and compliance practices. This position requires an influential leader who can navigate complex regulatory environments, drive organizational change, and deliver measurable business outcomes.
Provides enterprise leadership for Medicaid provider compliance, audit management, and regulatory oversight activities. Leads the development and execution of compliance strategies that support contractual, regulatory, and business objectives while promoting a culture of accountability, continuous improvement, and risk awareness. Serves as a recognized subject matter expert for provider compliance and audit readiness, driving initiatives that improve data integrity, strengthen internal controls, standardize processes, and enhance organizational performance. Partners across business areas to influence strategic decisions, manage emerging compliance risks, and ensure successful execution of high-impact compliance initiatives. The ideal candidate combines deep regulatory expertise, exceptional analytical capabilities, executive-level communication skills, and proven success leading complex initiatives that drive sustainable compliance outcomes.
Anticipated Weekly Hours
40The typical pay range for this role is:
$54,300.00 - $159,120.00This 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.
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.
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Simplifying health care one person, one family and one community at a time
CVS Health is the leading health solutions company, delivering care like no one else can. We reach more people and improve the health of communities across America through our local presence, digital channels and over 300,000 dedicated colleagues. Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by simplifying health care one person, one family and one community at a time. Follow @CVSHealth on social media.
Offices: 1 CVS Drive, Woonsocket, RI 02895, US · 9501 E. Shea Blvd, Scottsdale, AZ 85260, US · 2211 Sanders Road, Northbrook, IL 60062, US · 750 West John Carpenter Freeway, Ste 1200, Irving, TX 75039, US · 620 Epsilon Dr, Pittsburgh, PA 15238, US
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