CVS Health · 4 hours ago
Manager, Medicaid Compliance
Scottsdale, AZ
Full-time
Hybrid
Mid, Senior Level
$60K/yr - $133K/yr
5+ years expCVS Health is dedicated to building a more connected and compassionate health experience. The Medicaid Compliance Manager will support the Mercy Care and Medicaid compliance program by developing systems and processes that promote compliant and ethical behavior, while also managing regulatory deliverables and providing training to team members.
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Responsibilities
Maintain the systems and tools to track, monitor, review, and submit required regulatory and compliance related deliverables and responses to Arizona Medicaid agencies on or before required due dates; prepares moderately complex regulatory reports as needed on behalf of the Medicaid compliance team
Conduct research and develop recommendations to help develop compliant business operations, processes and policies in accordance with Arizona specific Medicaid program requirements
Develop compelling and appropriate compliance related communications on behalf of Mercy Care in response to Arizona Medicaid agency inquiries or requests
Maintain an in-depth working knowledge of the Mercy Care’s contractual, regulatory, and program policy related obligations as a Medicaid managed care organization and serve as a resource to Mercy Care and Medicaid growth partner staff for education and business decision making purposes
Manage and support the external audit review process in conjunction with designated subject matter experts at Mercy Care, including, but not limited to the project management and tracking of required deliverables, responses, and corrective action plan development (through closure)
Maintain current resource 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 tools as needed to ensure the appropriate monitoring and oversight of Mercy Care and Medicaid compliance processes
Utilize systems unique to job functions, including standard-issue software such as Microsoft products and 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
Conduct oversight and monitoring to evaluate levels of compliance with Mercy Care requirements across 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
Maintain positive, productive relationships with internal and external constituents to effectively communicate and influence ethical and compliant outcomes
Provide training and guidance to less experienced team members to accomplish goals
Other duties as assigned
Qualification
Required
Minimum of 5 years of regulatory compliance position in managed care, health care, or insurance
Project management experience
Bachelor's degree in Public Policy, Government Affairs, Healthcare Administration, Public Administration, or a related field; equivalent work experience may substitute
Preferred
Experience with Medicaid or Medicaid managed care
Advanced degree (Masters degree or Juris Doctor) is a plus
Benefits
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
Company
CVS Health
CVS Health is a health solutions company that provides an integrated healthcare services to its members.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$4BKey Investors
Michigan Economic Development CorporationStarboard Value
2025-08-15Post Ipo Debt· $4B
2025-07-17Grant· $1.5M
2019-11-25Post Ipo Equity
Leadership Team
David Joyner
President and Chief Executive Officer, CVS Health
Chandra McMahon
SVP & CISO
Recent News
2026-01-25
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