Medicaid Compliance Consultant
Job Summary
To enhance the Medicaid Compliance Program, the full-time remote Medicaid Compliance Consultant will manage compliance activities, develop functional procedures, monitor performance metrics, and conduct education and training on compliance issues.
Key responsibilities:
- Develop compliance reports by evaluating compliance data and summarizing audit information
- Conduct compliance investigations by analyzing data, conducting interviews, and creating corrective action plans
- Coordinate the implementation of compliance efforts by identifying requirements and monitoring adherence to standards
Required qualifications:
- Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or related field
- Minimum six (6) 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 advantageous
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