Senior Analyst, Provider Compliance

CVS Health•Washington, NV

4d•$46,988 - $112,200

About The Position

CVS Health is seeking a Senior Analyst, Provider Compliance to lead Medicaid provider compliance, audit excellence, and regulatory integrity. The role is responsible for high-quality internal and external Medicaid provider audit results, regulatory compliance activities, and proactive risk mitigation. It applies expertise in compliance, business operations, analytics, and communication to support regulatory and contractual obligations. The position partners across teams to deliver accurate, complete, and timely audit and regulatory materials; standardizes processes; optimizes workflows; and supports data integrity and provider compliance initiatives. The successful candidate will be a strategic, solutions-oriented leader who can influence outcomes, manage complex initiatives, and promote effective audit performance, regulatory relationships, and operational efficiency.

Requirements

At least 3 years of progressive experience in audit, compliance, or related healthcare operations.
Ability to develop and execute detailed project plans with accountability and rigor to deliver complex initiatives.
Strong analytical skills, including interpreting data, identifying trends, and recommending actionable solutions for compliance-related challenges.
Advanced proficiency with Microsoft Excel for data analysis and reporting to strengthen internal controls and mitigate risk.
Ability to communicate complex information clearly and concisely, build relationships across organizational levels, and influence decision-making.
Ability to lead initiatives, mentor team members, and work effectively in a fast-paced, evolving environment while maintaining compliance and quality standards.
Bachelor's degree, specialized training, or a relevant professional qualification.

Nice To Haves

5 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 affecting healthcare operations.
At least 3 years of success leading audits and complex projects, ensuring timely delivery, and driving measurable outcomes.
At least 3 years of experience managing provider data operations, including compliance.
At least 3 years of experience in network management, contracting, or related healthcare network functions.
At least 1 year of hands-on experience with provider data management platforms.
Bachelor's degree preferred.

Responsibilities

Collaborate with internal teams and external auditors to deliver quality results, support continuous improvement, and maintain compliance.
Interpret audit findings and recommend sustainable corrective actions and process improvements to mitigate risk.
Support responses 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 development of policy and procedural documentation and ensure required annual reviews are completed on time.
Build productive partnerships across organizational levels, exercise sound judgment, remove barriers, and influence ethical and compliant outcomes in support of strategic goals.
Support accurate, complete, and timely audit and regulatory deliverables, process standardization, workflow optimization, and data integrity.
Drive and support provider compliance initiatives that promote consistency, accuracy, compliance, and operational excellence.