Maryland Licensed Medicaid Compliance Consultant

Job Summary

To enhance the Medicaid Compliance Program, the full-time Maryland Licensed Medicaid Compliance Consultant will advise regional staff on contractual and regulatory requirements, develop compliant procedures, monitor performance metrics, conduct risk assessments, and provide training on compliance issues, all while working remotely.

Key responsibilities

• Develop compliance reports by evaluating data and summarizing key performance indicators
• Conduct compliance investigations, including data analysis and interviews to identify corrective action steps
• Coordinate the implementation of compliance efforts by assessing current compliance status and revising standards and procedures

Required qualifications

• Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or related field
• Minimum six years of experience in compliance, health care operations, audit, or related fields
• Experience in health plan compliance and operations preferred
• Project management experience is a plus
• Certification in Healthcare Compliance (CHC) or equivalent is advantageous