Senior Analyst, Corporate Compliance
CVS Health
Posted: 10/20/2026
Executive Director – Research & Development Compliance, Global Medical and Scientific Affairs
MSD
Posted: 10/20/2026
Senior Regulatory Affairs Specialist
Solventum
Posted: 10/20/2026
Senior Quality Compliance Manager
Amgen
Posted: 10/20/2026Google Cloud Platform
Senior Director, Regulatory Affairs CMC
Braveheart Bio
Posted: 10/20/2026
Head of Compliance Services
Verista, Inc.
Posted: 10/20/2026
Compliance Professional
Humana
Posted: 10/20/2026
Manager – CMC Regulatory Affairs
Regeneron
Posted: 10/20/2026
Senior Information Assurance Policy and Compliance Certified Professional
Accenture Federal Services
Posted: 10/20/2026Cyber SecurityFirewallsTCP/IP
Regulatory Risk and Compliance Manager – Health Industries, Revenue Excellence
PwC
Posted: 10/20/2026
Partner Compliance Manager
Del Oro Consulting, Inc.
Posted: 10/20/2026
Manager, Specialty Compliance and Ethics – Health & Wellness Compliance
Walmart
Posted: 10/20/2026
Manager, Compliance, Privacy Advisor
Capital One
Posted: 10/20/2026
Senior Lead, Insurance Compliance & Regulatory
Jerry
Posted: 10/20/2026T
Compliance Specialist
Timothy Padgett
Posted: 10/20/2026
Compliance Analyst
Southend Pharmacy
Posted: 10/20/2026
Environmental Compliance Specialist
OWL Services
Posted: 10/20/2026
Senior Regulatory Specialist
Evergen (Formerly RTI Surgical)
Posted: 10/20/2026Senior Regulatory Specialist
Evergen (Formerly RTI Surgical)
Posted: 10/20/2026
Compliance Specialist
Dane Street
Posted: 10/20/2026Senior Analyst, Corporate Compliance
CVS HealthCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare compliance, billing, coding, and risk adjustment, with a strong focus on analyzing claims and medical records to identify compliance risks and recommend solutions. Proficient in collaborating across various teams and communicating complex information effectively.
Highest-signal resume keywords
Healthcare Compliance MonitoringHCC CodingRisk Adjustment ProgramsCertified Professional Coder (CPC)Claims Data Analysis
About the role
Key responsibilities & impact- Execute assigned healthcare compliance monitoring activities
- Apply healthcare compliance, billing, coding, and risk adjustment knowledge to complex or concurrent reviews across multiple business areas
- Coordinate assigned monitoring activities
- Report results and follow up on identified issues
- Communicate compliance risks and business impacts
- Review medical records, claims data, diagnosis codes, modifiers, and supporting documentation
- Evaluate the accuracy, completeness, and support of HCC submissions, RAF impact, billed services, and coding outcomes
- Collaborate with Compliance, Legal, clinical operations, billing, coding, finance, and business teams
- Facilitate meetings and communicate information to management and stakeholders
- Execute and document monitoring testing
- Analyze claims, encounter, billing, coding, and documentation data to identify trends, outliers, control gaps, and compliance risks
- Recommend practical solutions and identify opportunities for automation and analytics
Requirements
What you’ll need- 2+ years of experience in healthcare compliance, auditing, monitoring, billing, coding, claims review, medical record review, risk adjustment, investigations, or risk assessments within a healthcare organization, provider practice, health plan, or government healthcare program
- Strong knowledge of CMS Medicare Part B and Part C requirements
- Strong knowledge of Medicare Advantage risk adjustment programs, HCC coding, RAF methodologies, provider documentation standards, medical record validation, coding compliance requirements, and documentation support standards
- Experience reviewing medical records, claims data, diagnosis codes, modifiers, and supporting documentation
- Strong analytical, deductive, problem solving, and critical thinking skills
- Willingness to travel up to 5% (including by plane)
- Ability to collaborate across Compliance, Legal, clinical operations, billing, coding, finance, and business teams
- Ability to facilitate meetings and communicate clearly in written and verbal form
- Regular and reliable attendance is an essential function of the role
- Ability to evaluate information, identify compliance risks, solve complex problems, and recommend practical solutions
- Ability to identify opportunities to use automation and analytics to improve monitoring efficiency
- Strong cross-functional communication and relationship-building skills
- Ability to coordinate activities, execute and document monitoring testing, and communicate results
- Experience analyzing claims, encounter, billing, coding, and documentation data
- Strong business acumen, organizational and time management skills, and attention to detail
- Bachelor's Degree; equivalent work experience may substitute
- High School Diploma/GED required
- Certified Professional Coder (CPC) required
Benefits
Comp & perks- CVS Health bonus, commission or short-term incentive program in addition to base pay
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Healthcare ComplianceBillingCodingClaims ReviewMedical Record ReviewRisk AssessmentData AnalysisDocumentation SupportMonitoring TestingProblem Solving
Soft Skills
Analytical SkillsCritical ThinkingCommunication SkillsRelationship BuildingOrganizational Skills
Certifications & Qualifications
Certified Professional Coder (CPC)
Industry Keywords
CMS Medicare Part BMedicare AdvantageHCC CodingRAF MethodologiesProvider Documentation StandardsCoding Compliance RequirementsMedical Record ValidationCompliance RisksAutomationAnalytics