Senior Compliance Professional, Medicaid
Core
Ensures compliance with governmental requirements for Medicaid business operations through auditing, monitoring, and regulatory analysis.
Role type
Senior Compliance Professional (Medicaid)
Builds
Compliance controls and audit methodologies for Medicaid operations
Domain
Healthcare / Medicaid Regulatory Compliance
Required skills
Regulatory law knowledge, Audit methodology, Risk management, Data analysis, Remediation planning, Regulatory interpretation
Preferred skills
Juris Doctor or MBA, Metrics reporting, Health Plan Operations experience
Technologies
None stated
Responsibilities
Develop audit methodology and perform auditing/monitoring to detect noncompliance; Present audit findings to business partners and track remediation; Review documents/data to evidence regulatory compliance; Interpret regulatory/contract requirements for implementation; Oversee Medicaid business operations to minimize risk; Support external audits and coordinate with regulators.
Seniority
Senior, hands-on IC