Senior Managed Care Oversight Analyst - Medicaid

State of Michigan; Michigan; Hybrid; USD 65,000 - 90,000; Full time

Job summary

The State of Michigan, in the MDHHS Office of Inspector General, seeks a Senior Managed Care Oversight Analyst to investigate and oversee Medicaid managed care entities. The role focuses on compliance, fraud, waste and abuse, and the development of oversight tools and contract reviews.

Candidate will interpret regulatory changes and guide program integrity statewide. Based in Michigan with potential hybrid/remote options, the position requires a bachelor’s degree and several years of state-level

Qualifications

• Bachelor's degree in any major.

Responsibilities

• Reviews and investigates the most complex activities and submissions related to Medicaid Managed Care Entities (MCEs) and MI Choice Waiver Agencies.
• Advises and provides guidance on regulatory changes; develops and updates oversight tools to evaluate and monitor program integrity.
• Conducts annual contract reviews and monitors corrective action plans, sanctions, and penalties for MCEs.

Education

Bachelor's degree

Job description

The State of Michigan, in the MDHHS Office of Inspector General, seeks a Senior Managed Care Oversight Analyst to investigate and oversee Medicaid managed care entities. The role focuses on compliance, fraud, waste and abuse, and the development of oversight tools and contract reviews.

Candidate will interpret regulatory changes and guide program integrity statewide. Based in Michigan with potential hybrid/remote options, the position requires a bachelor’s degree and several years of state-level