Position SummaryThe Corporate Medicaid Business Compliance Office (BCO) Team is looking for a driven, high-performance leader responsible for the oversight of the Medicaid Contract Amendment (MCA) Program. This role is responsible for overseeing the identification, assessment, compliance oversight, and tracking of new and amended Medicaid contractual requirements across the Medicaid plans.
The ideal candidate has strong knowledge of Medicaid managed care and compliance processes, with experience supporting state contract requirements, compliance operations, systems, and cross-functional workflows. They are highly organized and have a proven track record of managing medium- to large-scale, cross-functional health plan initiatives. The Sr. Manager will oversee multiple market-specific amendments by coordinating BCO team activities, documenting and communicating contractual changes, facilitating collaboration among Compliance, health plans, and business stakeholders, monitoring amendment-related compliance activities, and maintaining compliance documentation and supporting artifacts. This role will also help identify issues, mitigate risk, facilitate collaborative solutions across teams, and support additional departmental goals, initiatives, and projects as needed.
The Day to Day- Lead and oversee compliance activities related to new and revised Medicaid contractual and regulatory requirements.
- Provide compliance oversight of amendment-related activities, including requirement tracking, stakeholder engagement, status monitoring, and evidence collection.
- Coordinate with Compliance, Health Plan, and business stakeholders through recurring and ad hoc touch points to provide guidance, monitor progress, and address barriers to compliance.
- Manage amendment intake, communications, and governance through centralized processes and tools.
- Review and oversee compliance portfolios, requirement trackers, and supporting documentation to ensure contractual obligations are appropriately tracked and supported by evidence.
- Maintain knowledge of Medicaid contract amendment processes and compliance oversight practices to effectively advise stakeholders and support compliance activities.
- Lead and organize team assignments, oversee day-to-day operations, and identify opportunities to improve compliance processes, controls, and reporting.
- Support enterprise Medicaid Compliance initiatives and regulatory readiness activities, including audits, examinations, and compliance reviews.
To be successful in this role you must exhibit the following:- Ability to work independently and effectively in a dynamic, complex, and collaborative environment.
- Experience advising, influencing, and building relationships across multiple levels of the organization.
- Strong skills in organizing, prioritizing, and managing multiple concurrent projects and deadlines.
- Exceptional attention to detail and a demonstrated ability to maintain accurate documentation and reporting.
- Strong business acumen with the ability to communicate complex information and present to senior leadership.
- Excellent written, verbal, and interpersonal communication skills.
- Experience analyzing information, identifying risks, and developing practical solutions to compliance and operational challenges.
- Proficiency in Microsoft Office applications, including Word, Excel, and PowerPoint.
- Proficiency with SharePoint, Microsoft Teams, and other collaboration and document management tools.
Required Qualifications- 7+ years healthcare/health insurance/industry experience related to complex projects and initiatives.
- 5+ years Medicaid managed care experience.
- 5+ years of contractual and/or compliance related experience.
- 5+ years of project lead experience or similar work experience.
- 3+ years leadership experience, influencing change, and driving positive outcomes.
- 5+ years in Microsoft applications (Word, Excel, PowerPoint).
Preferred Qualifications- Strong interpersonal and communication skills, including the ability to interact and influence at various levels of the organization.
- Experience conducting legislative, regulatory, contractual, or policy research.
- Knowledge of state and federal healthcare laws and regulations, particularly within Medicaid managed care.
- Familiarity with Governance, Risk, and Compliance (GRC) tools and compliance tracking systems.
- Ability to analyze complex issues, identify risks and root causes, and develop practical solutions.
Education- Bachelor's degree required or equivalent years of related experience.
Pay RangeThe typical pay range for this role is:
$75,400.00 - $182,549.00
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. This position also includes an award target in the company's equity award program.
Great benefits for great peopleWe take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 09/28/2026
