Senior Analyst, Provider Compliance

Medicaid Provider Compliance LeaderAt 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. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryLeads 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 ResponsibilitiesDirect and foster best-in-class collaboration with internal teams and external auditors to deliver quality results, ensure continuous improvement, and maintain compliance. Interpret audit findings to recommend sustainable corrective actions and process improvements that mitigate risk. Support the response to complex inquiries from internal stakeholders and regulators with accuracy, timeliness, and completeness. Serve as a technical and functional leader, managing multiple compliance-related projects and deliverables to ensure timely execution and desired outcomes. Oversee policy and procedural documentation development and the timeliness of required annual reviews. Build and sustain productive partnerships across all organizational levels; exercise sound judgment, remove barriers, and influence ethical, compliant outcomes to achieve strategic goals.Required QualificationsMinimum of 3 years of progressive experience in audit, compliance, or related healthcare operations. Proven ability to develop and execute detailed project plans with accountability and rigor to deliver complex initiatives successfully. Strong analytical skills with demonstrated ability to interpret data, identify trends, and recommend actionable solutions for compliance-related challenges. Experience with Microsoft Excel with advanced proficiency for data analysis and reporting to strengthen internal controls and mitigate risk. Exceptional ability to convey complex information clearly and concisely, build relationships across organizational levels, and influence decision-making. Ability to lead initiatives, mentor team members, and thrive in a fast-paced, evolving environment while maintaining compliance and quality standards.Preferred Qualifications5 years of progressive experience in audit, compliance, or related healthcare operations. Ability to interpret and apply business knowledge to implement state and federal laws and regulations impacting healthcare operations. Three or more years of demonstrated success leading audits, complex projects, ensuring timely delivery, and driving measurable outcomes. Three or more years of experience managing provider data operations, including compliance. Three or more years of experience in network management, contracting, or related healthcare network functions. One or more years of hands-on experience with provider data management platforms.EducationBachelor's degree preferred/specialized training/relevant professional qualification.Anticipated Weekly Hours40Time TypeFull timePay RangeThe 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 PeopleWe 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: 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. For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe 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.