Medicaid Compliance Officer
$140-175K DOE

We are seeking a dynamic Medicaid Compliance Officer to lead multi-disciplinary teams and ensure adherence to all Medicaid policy, contract requirements, and governing laws. This role is responsible for maintaining quality assurance and compliance programs that exceed stakeholder expectations, while building strong relationships with both internal teams and external government agencies. This is a hybrid role requiring onsite presence in Syracuse, NY.

Key Responsibilities:

• Build and maintain relationships with internal leadership, external stakeholders, and government agencies, including the NYS Department of Health.
• Oversee compliance programs, including fraud monitoring, provider access, and government reporting.
• Lead the Customer Quality Assurance program, including complaint resolution, customer feedback, and call auditing.
• Direct the Utilization Review/Clinical team in managing medical necessity forms and fair hearings.
• Oversee special projects and ensure full compliance with Medicaid policies and audits.

Qualifications:

• Bachelor’s degree required; at least 10 years in a senior leadership role within a related field.
• Strong understanding of Medicaid laws, corporate compliance programs, and relevant state and federal policies.
• Proven ability to lead diverse teams and manage multiple projects simultaneously.
• Excellent interpersonal, communication, and relationship-building skills.

Apply Today:
Submit your resume to profhr@cpsrecruiter.com for confidential consideration.

CPS Recruitment is an EOE

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