Medicaid Compliance & Program Integrity Lead

BerryDunn — Assurance, Tax and Consulting; United States; On-site; USD 95,000 - 130,000; Full time

Job summary

BerryDunn is seeking a Medicaid Compliance Subject Matter Expert (SME) to provide expert guidance on federal and state Medicaid requirements, compliance monitoring, and audit readiness.

This role will partner with cross-functional BerryDunn project teams, state stakeholders, and program integrity experts to interpret requirements, assess risks, document processes, and support system and operational improvements.

Qualifications

• Experience with Medicaid compliance, Program Integrity, TPL, PERM, audit response, or corrective action planning.
• Strong policy interpretation, documentation, and risk assessment skills.
• Experience working across operational, policy, analytical, and leadership stakeholders.

Responsibilities

• Interpret Medicaid regulatory, Program Integrity, TPL, PERM, and compliance requirements relevant to the engagement.
• Support compliance assessments, audit readiness activities, and documentation of risks and gaps.
• Develop recommendations, corrective action approaches, and process improvements to address compliance findings.
• Support responses to CMS, state, or stakeholder requests related to Medicaid Program Integrity and FWA activities.
• Support development and refinement of monitoring approaches, review protocols, and repeatable compliance review processes.
• Translate compliance findings and policy interpretations into practical recommendations for process updates.
• Support documentation quality, issue escalation, decision tracking, and follow-through across the project.
• Collaborate with policy, program, analytics, and project leadership to align findings and coordinate recommendations.
• Review policies, procedures, workflows, and materials for compliance considerations.
• Support Medicaid system and operational improvement efforts by applying program knowledge to workflows and training needs.

Skills

Medicaid compliance

Program Integrity

TPL

PERM

Audit response

Corrective action planning

Job description

BerryDunn is seeking a Medicaid Compliance Subject Matter Expert (SME) to provide expert guidance on federal and state Medicaid requirements, compliance monitoring, and audit readiness.

This role will partner with cross-functional BerryDunn project teams, state stakeholders, and program integrity experts to interpret requirements, assess risks, document processes, and support system and operational improvements.