Oregon Licensed Medicaid Compliance Consultant

Job Summary

To enhance the Medicaid Compliance Program, the full-time Oregon Licensed Medicaid Compliance Consultant will collaborate with regional staff to ensure adherence to contractual and regulatory requirements, develop compliance reports, conduct investigations, and support training initiatives remotely.

Key responsibilities

• Maintain and enhance the Medicaid Compliance Program by advising on regulatory requirements and developing compliant procedures
• Conduct compliance investigations and develop corrective action plans based on audit findings and compliance metrics
• Collaborate with stakeholders to implement compliance efforts and monitor adherence to regulatory changes

Required qualifications

• Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or a 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
• Proven ability to work cross-functionally across departments
• Project management experience