Maryland Licensed Medicaid Compliance Consultant

Job Summary

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

Key responsibilities

• Develop compliance reports by evaluating data and summarizing audit information and potential risks
• Conduct compliance investigations by analyzing data, conducting interviews, and creating corrective action plans
• Coordinate the implementation of compliance efforts by assessing current compliance states and revising standards and procedures

Required qualifications

• Bachelor's degree in Health Care Administration, Law, Public Health, Business, or a related field
• Minimum six years of experience in compliance, health care operations, audit, or regulatory development
• Experience in health plan compliance and operations is preferred
• Project management experience is beneficial
• Master's degree or compliance certification is a plus