Medicaid TPL Lead: Cost Recovery & Program Integrity

BerryDunn — Assurance, Tax and Consulting; United States; On-site; USD 90,000 - 120,000; Full time

Job summary

BerryDunn seeks a Third Party Liability Lead to support Hawai‘i Med-QUEST’s TPL initiatives, program integrity, and Medicaid TPL operations. You will lead TPL activities, coordinate with MQD and vendors, and drive improvements in cost avoidance, recovery, and documentation.

Travel up to 25% and collaboration with cross‑functional teams to align TPL requirements with policy, audit, and systems priorities. The role emphasizes leadership, analytical rigor, and compliance with federal/state Medicaid

Responsibilities

• Lead TPL operations and improvements, including cost avoidance, recovery, lien-related processes, vendor coordination, reporting, and quality assurance.
• Oversee the TPL SME’s work, including analysis, recommendations, documentation, operational support, and quality review.
• Coordinate with the Program Integrity Lead and Policy Lead to align TPL activities with broader compliance, audit, policy, process, and systems priorities.
• Provide guidance to project teams and stakeholders on Medicaid TPL requirements, best practices, operational considerations, and compliance expectations.
• Support daily TPL Unit operations, including coordination with MQD units, vendors, health plans, the Civil Recoveries Division, and other partners.
• Lead or support development, tracking, and refinement of TPL lien-related processes and documentation.
• Facilitate meetings, manage follow-up actions, track decisions, elevate risks and blockers, and support timely issue resolution.
• Review existing TPL processes and lead business process redesign to improve efficiency, compliance, accountability, and recovery outcomes.
• Review TPL vendor lead files, verified policy updates, cost avoidance reports, recovery reports, and related operational data.
• Follow project ways-of-working standards, including document management, client communication, time entry, internal review cycles, and protection of sensitive information.

Job description

BerryDunn seeks a Third Party Liability Lead to support Hawai‘i Med-QUEST’s TPL initiatives, program integrity, and Medicaid TPL operations. You will lead TPL activities, coordinate with MQD and vendors, and drive improvements in cost avoidance, recovery, and documentation.

Travel up to 25% and collaboration with cross‑functional teams to align TPL requirements with policy, audit, and systems priorities. The role emphasizes leadership, analytical rigor, and compliance with federal/state Medicaid