Medicaid Quality & Compliance Specialist

Indiana; Indianapolis (IN); On-site; USD 61,000 - 74,000; Full time

Benefits offered by this job

Medical plan options

Wellness rewards program

Health savings account

Retirement/pension benefits

Paid leave and holidays

Education reimbursement

LinkedIn Learning access

Job summary

The State of Indiana seeks a Clinical Quality Specialist to oversee quality assurance and regulatory compliance for Indiana Medicaid programs. You will collaborate with vendors, MCEs, and state agencies to drive data-driven improvements and ensure federal and state adherence.

Required are RN or LPN credentials with significant clinical experience or an associate degree with substantial relevant work history. Expect public-speaking, negotiation, and occasional in-state travel as part of the role.

Qualifications

• Physically and academically capable of managing clinical quality and compliance.
• Experience with healthcare quality programs and analytics is preferred.
• Strong communication and stakeholder engagement skills.
• Ability to interpret complex policies and translate them into actionable plans.

Responsibilities

• Establish, monitor, and implement long-range objectives with KPIs and actions.
• Analyze operations to evaluate performance and identify cost savings or improvements.
• Explain policies and regulations to diverse audiences, including officials and partners.
• Develop corrective action plans to resolve organizational issues.
• Prepare and present reports for funding, oversight, or governance bodies.
• Oversee program budgeting and ensure grants compliance.
• Coordinate and deliver training on program requirements and usage.
• Lead or participate in boards or committees and manage workflow.

Skills

RN License

LPN License

10+ years clinical experience

Education

Associate’s Degree in clinical discipline

Job description

The State of Indiana seeks a Clinical Quality Specialist to oversee quality assurance and regulatory compliance for Indiana Medicaid programs. You will collaborate with vendors, MCEs, and state agencies to drive data-driven improvements and ensure federal and state adherence.

Required are RN or LPN credentials with significant clinical experience or an associate degree with substantial relevant work history. Expect public-speaking, negotiation, and occasional in-state travel as part of the role.