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 advise on contractual and regulatory requirements, develop compliant procedures, monitor performance metrics, conduct risk assessments, and provide education on compliance issues, all while working remotely.

Key responsibilities

• Develop compliance reports by evaluating data and summarizing key compliance drivers and performance indicators
• Conduct compliance investigations by collecting and analyzing data, conducting interviews, and creating corrective action plans
• Coordinate the implementation of compliance efforts by assessing current compliance states, identifying gaps, and revising standards and policies

Required qualifications

• Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or a related field
• Minimum of six (6) years of experience in compliance, health care operations, audit, finance, or regulatory development
• Experience in health plan compliance and operations
• Project management experience
• Ability to work cross-functionally across departments