Medicaid Compliance Specialist

1 week ago


Lansing, Michigan, United States State of Michigan Full time

About the Position:
This role serves as a crucial link between the Department of Health and Human Services (MDHHS) and various Integrated Care Organizations (ICOs) that deliver integrated health care services. The focus is on ensuring effective care coordination for individuals eligible for both Medicaid and Medicare.

Key Responsibilities:
As a senior-level analyst, you will be responsible for:

  • Conducting on-site evaluations and participating in site visit teams.
  • Acting as a primary contact for providers, associations, and local agencies.
  • Engaging with ICOs through various communication channels including phone, email, and in-person meetings.
  • Monitoring and ensuring compliance with contractual obligations of the ICOs.
  • Advocating for the resolution of service-related issues.
  • Enhancing the operational capabilities of ICOs as Medicaid/Medicare providers.

Qualifications:
To be eligible for this position, candidates must possess:

  • A bachelor's degree in any field.
  • A minimum of three years of professional experience, including at least one year at the experienced (P11) level in state service.

Work Environment:
This position may offer flexibility in work arrangements, including remote or hybrid options, subject to operational needs.

Application Process:
Interested candidates must submit their applications electronically, including a resume detailing relevant experience and a cover letter. Official transcripts may be required if applicable.

Additional Information:
Successful candidates will undergo a background investigation and criminal records check as part of the employment process. The use of artificial intelligence in the application process is strictly prohibited.



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