Lead Director – Corporate Compliance

CVS Health

Lead Director managing compliance activities for Aetna’s Illinois Medicaid health plan. Oversee audits, facilitate communications and support teams for regulatory compliance.

Posted 7/14/2026full-timeRemote • Illinois • 🇺🇸 United StatesSenior💰 $100,000 - $231,540 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates extensive knowledge of Medicaid compliance requirements and effective project management skills, with a strong ability to communicate and influence compliance outcomes. Proven experience in audit management and training team members to ensure adherence to regulatory standards.

Highest-signal resume keywords

Medicaid Compliance ManagementProject Management SkillsAudit ExperienceRegulatory ReportingTeam Leadership

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medicaid Managed CareCompliance Program DevelopmentRisk AssessmentPolicy DevelopmentContract Management

Soft Skills

CommunicationRelationship ManagementTraining and Mentoring

Tools & Technologies

Microsoft ProductsArcher Compliance Tool

Certifications & Qualifications

Master’s Degree in Public PolicyMaster’s Degree in Health Care AdministrationMaster’s Degree in Public AdministrationLaw Degree

Industry Keywords

MedicaidManaged Care OrganizationRegulatory ComplianceExternal AuditsHealth Plan Operations

About the role

Key responsibilities & impact

Serve as the designated Compliance Officer for Aetna’s IL Medicaid health plan
Acts as the primary liaison to the state Medicaid agency, facilitating compliance and contract-related communications and activities.
Facilitates the preparation for and management of external audits conducted by state Medicaid and related agencies or partners
Lead and execute all elements of the Medicaid compliance program for Aetna’s IL Medicaid health plan.
Conduct research and develop recommendations to help develop compliant business operations, processes and policies in accordance with state specific Medicaid program requirements.
Develop compelling, strategic, and appropriate compliance related communications on behalf of the health plan in response to state Medicaid agency inquiries or requests.
Maintain an in-depth working knowledge of the health plan’s contractual, regulatory, and program policy related obligations as a Medicaid managed care organization and serve as a resource to health plan and growth partner staff for education, training, and business decision making purposes.
Ensure that current resource tools and other internal deliverables such as current contract library, regulatory reporting assignments, risk assessments, risk tracking lists, internal reporting systems and summaries, and other department wide tools are current and accessible to business partners to ensure the appropriate monitoring and oversight of health plan compliance processes.
Utilize systems unique to job functions, including standard-issue software such as Microsoft products and compliance specific tools such as Archer; maintain system documentation, serve as subject matter expert, train users of system, contribute to system design, oversight or maintenance.
Lead and direct oversight and monitoring activities to evaluate levels of compliance with new and existing Medicaid managed care organization requirements across the business; support business partners in the development of mitigation and corrective action plans and effectively escalate risks, concerns and other issues through appropriate channels.
Maintain positive, productive relationships with internal and external senior level constituents to effectively communicate and influence ethical and compliant outcomes.
Oversee the submission of required regulatory reports (standard and ad hoc), including the completion of high level quality reviews prior to submission and the maintenance of tracking systems and tools to document ownership, reporting requirements, and monitor timely delivery and acceptance of reports.
Provide training and guidance to less experienced team members to accomplish goals.
Other duties as assigned.

Requirements

What you’ll need

10+ years of previous experience in Medicaid or Medicaid managed care
5+ years of roles that required use of project management skills and responsibilities
2+ years of previous management experience
Audit experience
Master’s degree in Public Policy, Health Care Administration, Public Administration or similar fields or a law degree
Bachelors degree required or equivalent years of related experience.

Benefits

Comp & perks

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
other resources