Maryland Medicaid Compliance Consultant

Job Summary

To enhance the Medicaid Compliance Program, the full-time remote Maryland Medicaid Compliance Consultant will manage compliance activities, develop functional procedures, monitor performance metrics, conduct risk assessments, and provide training on compliance issues.

Key responsibilities

• Develop compliance reports by evaluating compliance data, audit information, and potential risks
• Conduct compliance investigations by collecting and analyzing data and providing input for corrective action plans
• Coordinate the implementation of compliance efforts by assessing current compliance states and revising policies and procedures as needed

Required qualifications

• Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or a related field
• Minimum six (6) years of experience in compliance, health care operations, audit, or related fields
• Experience in health plan compliance and operations preferred
• Project management experience, ideally two (2) years
• Certification in Healthcare Compliance (CHC) or equivalent is a plus