CVS Health
Senior Analyst, Corp Compliance
$47K–$112K
RI - Work from home +3 · Remote · Senior · Full-time · Posted Oct 20, 2026
- Location
- RI - Work from home
IL - Work from home
CT - Work from home
TX - Work from home - Experience
- 2+ years in one or more of the listed healthcare fields.
- Education
- Bachelor’s degree; equivalent work experience may substitute. High school diploma/GED required.
About the job
Executes healthcare compliance monitoring reviews, evaluates coding and risk-adjustment accuracy, and reports findings and risks to business partners.
What you'll do
- Conduct assigned compliance monitoring activities, including medical record, claims, and coding reviews.
- Coordinate monitoring work, document testing, report results, and follow up on issues.
- Analyze compliance data to identify risks, trends, outliers, and control gaps.
What they ask for
- 2+ years of relevant healthcare compliance, audit, monitoring, billing, coding, claims review, medical record review, risk adjustment, investigation, or risk assessment experience.
- Strong knowledge of Medicare Part B and Part C requirements, Medicare Advantage risk adjustment, HCC coding, RAF methodologies, documentation standards, and coding compliance.
- Experience reviewing medical records, claims data, diagnosis codes, modifiers, and supporting documentation for accuracy and support.
- Certified Professional Coder (CPC) required; willingness to travel up to 5%.
Nice to have
- Ability to collaborate across compliance, legal, clinical, billing, coding, finance, and business teams.
- Experience analyzing claims, encounter, billing, coding, and documentation data to identify risks and trends.
Pay
$46,988.00 - $112,200.00 (base hourly rate or base annual full-time salary; currency not stated)
Model-written summary · the original posting is authoritative