Medicaid Integrity Audits & Investigations Lead

State of Iowa; Des Moines (IA); On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Health, Dental, Vision

Paid Time Off

IPERS Retirement Plans

Flexible Spending Accounts

Life Insurance

Employee Assistance Program

Employee Discounts

Job summary

State of Iowa seeks a Compliance Officer for Medicaid Audits & Investigations to oversee enforcement activities, ensure program integrity, and coordinate with the Attorney General’s staff. The role serves as SME on audits and investigations within the Division.

The position requires reviewing procedures, assessing risks, and advising on compliance with federal and state requirements. Strong communication with internal and external teams is essential.

Qualifications

• Five years of full-time investigative or closely related work experience.
• Experience interpreting and enforcing federal and state health care laws or program requirements.
• Background in quality assurance review or internal audits to assess compliance.

Responsibilities

• Lead and coordinate Iowa Medicaid PI audits and investigations.
• Establish a QA program to promote integrity of program operations.
• Advise state Medicaid and vendor teams on compliance with federal/state laws.
• Coordinate external audits by state, vendors and managed care entities.
• Communicate findings and recommendations to stakeholders clearly.

Skills

Analytical thinking

Policy interpretation

Communication skills

Risk assessment

Education

Bachelor's degree

Law degree

Job description

State of Iowa seeks a Compliance Officer for Medicaid Audits & Investigations to oversee enforcement activities, ensure program integrity, and coordinate with the Attorney General’s staff. The role serves as SME on audits and investigations within the Division.

The position requires reviewing procedures, assessing risks, and advising on compliance with federal and state requirements. Strong communication with internal and external teams is essential.