The role involves providing strategic and technical advisory services on program integrity, compliance, and fraud prevention across various Health and Human Services (HHS) programs, including Medicaid, SNAP, and child welfare.
Responsibilities include leading risk assessments, designing and implementing integrity frameworks, overseeing audits and investigations, and developing data-driven detection strategies. The role also involves guiding regulatory compliance, supporting provider and participant integrity activities, and contributing to thought leadership through industry engagement and business development.
Qualifications require a minimum of eight years of relevant experience in program integrity or compliance roles supporting federal or state HHS programs, with a strong understanding of Medicaid laws and regulations. An advanced degree and relevant certifications (e.g., CFE, CPA, PMP) are preferred. The candidate must demonstrate leadership skills, experience in Medicaid finance, and excellent communication abilities. Willingness to travel is expected, and applicants must be authorized to work in the U.S. without sponsorship.
Additional duties include team management, client relationship building, and contributing to business growth, all within a collaborative and ethical work environment.