Medicaid Compliance & Program Integrity Lead

New Mexico Department of Justice; Albuquerque (NM); On-site; USD 70,000 - 110,000; Full time

Job summary

The Health Care Authority is seeking a Program Integrity Manager to monitor compliance with federal and state Medicaid regulations, coordinate reporting to CMS, OIG, HHS and GAO, and oversee audits. The role maintains documentation and updates compliance plans and procedures to reflect current rules and risks.

Ideal candidates will have Medicaid/public-sector experience, ability to coordinate across eligibility, payments and policy teams, and a proven track record in integrity risk mitigation

Qualifications

• Experience managing program integrity, compliance, or oversight within Medicaid or public-sector programs.
• Ability to coordinate across eligibility, payments and policy teams.
• Experience developing and implementing integrity controls and procedures.

Responsibilities

• Monitor compliance with CFR, NM Administrative Code and Medicaid regulations.
• Coordinate reporting to CMS, OIG, HHS and GAO; coordinate audits.
• Maintain audit/training/compliance documentation and update plans and procedures.

Skills

Program integrity management

Compliance oversight

Cross-functional coordination

Reporting & documentation

Education

Bachelor's degree in a relevant field

Job description

The Health Care Authority is seeking a Program Integrity Manager to monitor compliance with federal and state Medicaid regulations, coordinate reporting to CMS, OIG, HHS and GAO, and oversee audits. The role maintains documentation and updates compliance plans and procedures to reflect current rules and risks.

Ideal candidates will have Medicaid/public-sector experience, ability to coordinate across eligibility, payments and policy teams, and a proven track record in integrity risk mitigation