Compliance Analyst, CVS Health

CVS Health

Location:
United States, Monroeville ▼
Orlando

Category:
Customer Service

Contract Type:
Employment contract

Salary:

43888.00 - 85068.00 USD / Year

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Job Description:

CVS Health Specialty Pharmacy is seeking a Compliance Analyst for its Monroeville, PA or Orlando, FL office to manage Medicaid regulation files and support audit teams within a team-focused environment. The role involves detailed file updates, payer regulation monitoring, and assistance in audit-related activities.

Job Responsibility:

Responsible for understanding and effectively updating each data field of the Medicaid regulations system files
Maintain and update Medicaid regulation system files in compliance with the update schedule
Research Medicaid regulatory codes and other state-published guidance
Receive Medicaid payer notices, remain informed of payer regulation changes and retain notices for future reference
Ensure that necessary departments are notified of changes to the Medicaid regulation system files
Assist the audit team in collecting necessary documentation as needed to support timely audit request responses
Assist with educating staff on departmental policies and procedures
Assist with any enterprise or department special projects as needed

Requirements:

1-3 years of health care billing and/or revenue cycle experience
1+ years of MS Office experience
Demonstrated ability to handle multiple tasks simultaneously and to prioritize accordingly
Proven ability to work with a high degree of accuracy and attention to detail
Excellent verbal and written communication skills
Able to work effectively with other internal/external functional departments
Must be able to commute to the Monroeville, PA office

Nice to have:

1+ years of Medicaid or Medicare regulations experience
1+ years of regulatory compliance experience
1+ years of managing contracts or reviewing contracts
Previous SharePoint and Excel experience
Bachelor’s degree or 3-5 years related industry experience

What we offer:

Affordable medical plan options
401(k) plan including matching company contributions
Employee stock purchase plan
No-cost programs including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
April 30, 2025

Expiration:
May 12, 2025

Employment Type:

Fulltime

Work Type:

Hybrid work

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Compliance Analyst