Medicaid Compliance Consultant

Job Summary

To enhance the Medicaid Compliance Program, the full-time Medicaid Compliance Consultant IV will maintain compliance with state regulations, develop functional procedures, conduct risk assessments, and provide training on compliance issues while working remotely.

Key responsibilities:

• Develop compliance reports and conduct investigations to ensure adherence to Medicaid regulations
• Coordinate compliance efforts and monitor performance against compliance metrics
• Collaborate with internal and external stakeholders to implement corrective actions based on audit findings

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
• Project management experience
• Ability to work cross-functionally across departments or business lines