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, develop compliance procedures, monitor performance metrics, conduct risk assessments, and provide training on compliance issues in a remote work environment.

Key responsibilities

• Develop compliance reports by evaluating data, summarizing audit information, and reporting key compliance drivers to management
• Conduct compliance investigations by analyzing data, interviewing stakeholders, and creating corrective action plans for substantiated allegations
• Coordinate the implementation of compliance efforts by assessing current compliance states, identifying gaps, and revising standards and training materials

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 preferred
• Project management experience is beneficial
• Certification in Healthcare Compliance (CHC) or equivalent is a plus