Maryland Medicaid Compliance Consultant

Job Summary

To enhance the Medicaid Compliance Program, the full-time Maryland Medicaid Compliance Consultant will collaborate with regional staff to advise on regulatory requirements, conduct compliance investigations, develop reports, and implement corrective actions in a remote work environment.

Key responsibilities

• Develop compliance reports by evaluating data and summarizing audit information and risks
• Conduct compliance investigations, including data analysis and interviews, to identify corrective actions
• Coordinate the implementation of compliance efforts, assessing current compliance states and identifying gaps

Required qualifications

• Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or a related field
• Minimum of 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
• Master's degree or compliance certification (e.g., CHC) is preferred