Medicaid Compliance Consultant

Job Summary

To enhance the Medicaid Compliance Program, the full-time remote Medicaid Compliance Consultant will advise regional staff on Medicaid requirements, develop compliance procedures, monitor performance metrics, and conduct training and investigations related to compliance issues.

Key responsibilities:

• Develop and implement compliance reports and corrective action plans based on audit findings
• Conduct compliance investigations and collaborate with stakeholders to ensure adherence to regulatory requirements
• Coordinate the implementation of compliance efforts by assessing current practices and identifying gaps

Required qualifications:

• Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or 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
• Certification in Healthcare Compliance (CHC) or equivalent is advantageous