Medicaid Compliance Consultant

Job Summary

To enhance the Medicaid Compliance Program, the full-time remote Medicaid Compliance Consultant IV will maintain compliance standards, conduct investigations, develop reports, and collaborate with internal and external stakeholders on regulatory requirements in Maryland and Virginia.

Key responsibilities:

• Develop compliance reports and monitor performance against Medicaid compliance metrics
• Conduct compliance investigations and assist in the development of corrective action plans
• Coordinate implementation of compliance efforts and provide training on compliance issues

Required qualifications:

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