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Compliance Lead
Skills
AnalyticsBusinessBusiness AnalyticsCompliance AuditingContract ManagementData AnalyticsFraud Investigations
What the job involves
The main requirements, responsibilities and hiring steps.
Requirements
- Bachelor's degree in a related field
- 3+ years of advanced experience in compliance related or managed care related field or Medicaid
- 3+ years of interpreting and guiding on health care regulations and compliance requirements
- 3+ years analyzing and reviewing metrics related to contract compliance
Nice to have
- Clear communicator
- Professional
- Impactful
Day to day
- Serve as dedicated Regulatory Compliance Officer for Michigan Medicaid contract, building strong relationships with market leaders and external regulators
- Oversee Medicaid operations from readiness review through contract duration, performing risk assessments and managing auditing and monitoring work plans
- Interpret state and federal requirements, review market documents and data, coordinate external audits, and report compliance issues to senior leadership