Senior Medicaid Compliance & Audit Specialist

Kaiser Permanente; Hyattsville (MD); On-site; USD 110,000 - 170,000; Full time

Job summary

Kaiser Permanente in Hyattsville, Maryland seeks a Compliance Consultant IV to maintain and enhance the Medicaid Compliance Program for the Mid-Atlantic States. The role advises regional staff on Maryland/Virginia Medicaid requirements, develops compliant procedures, monitors metrics, and supports audit activities.

This individual contributor will develop compliance reports, conduct investigations, coordinate implementation of compliance efforts, and support regulatory compliance through

Qualifications

• Minimum qualifications include a Bachelor's degree and at least 6 years experience in compliance, health care operations, audits, finance, regulatory or policy development, investigations, information security, or governance.
• Master's degree and CHC certification are preferred in the listing, but not required for this role.

Responsibilities

• Contributes to Medicaid compliance program by developing procedures compliant with state Medicaid requirements.
• Conducts compliance investigations by collecting data, interviewing stakeholders, and proposing corrective actions.
• Coordinates compliance initiatives across internal and external stakeholders; manages project plans and schedules.

Skills

Ambiguity management

Attention to detail

Business knowledge

Communication

Critical thinking

Cross-group collaboration

Decision making

Dependability

Diversity and inclusion

Drives results

Facilitation skills

Health care industry

Influencing others

Integrity

Learning agility

Organizational savvy

Problem solving

Learning recall

Teamwork

Topic-specific communication

Education

Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business or related field

Job description

Kaiser Permanente in Hyattsville, Maryland seeks a Compliance Consultant IV to maintain and enhance the Medicaid Compliance Program for the Mid-Atlantic States. The role advises regional staff on Maryland/Virginia Medicaid requirements, develops compliant procedures, monitors metrics, and supports audit activities.

This individual contributor will develop compliance reports, conduct investigations, coordinate implementation of compliance efforts, and support regulatory compliance through