Medicaid Compliance Consultant

Job Summary

To enhance the Medicaid Compliance Program, the full-time remote Medicaid Compliance Consultant will manage compliance activities, develop reports, conduct investigations, and collaborate with internal and external stakeholders to ensure adherence to regulatory requirements in Maryland and Virginia.

Key responsibilities:

• Develop and monitor compliance reports and metrics while advising regional staff on Medicaid requirements
• Conduct compliance investigations and assist in the creation of corrective action plans based on audit findings
• Coordinate the implementation of compliance efforts and ensure adherence to established standards and regulations

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 related fields
• Experience in health plan compliance and operations preferred
• Demonstrated project management experience
• Certification in Healthcare Compliance (CHC) or equivalent compliance certification is a plus