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Company

LIBERTY Dental Plan · 5 hours ago

Compliance Officer Nevada State Medicaid

United States

Full-time

Remote

Senior Level

$130K/yr - $150K/yr

6+ years exp

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No H1B

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Responsibilities

Ensure compliance with all Nevada state Medicaid regulations, including the Department of Health Care Services (DHCS) and other applicable government agencies.

Develop, implement, and monitor compliance programs specific to Medicaid dental insurance services.

Collaborate with Corporate Compliance on audits and regulatory reviews, ensuring preparedness and addressing findings effectively.

Establish and enforce standards and procedures to prevent, detect, and correct improper or illegal conduct.

Collaborate with the legal and operations teams to assess and mitigate compliance risks related to Medicaid contracts and services.

Serve as the point of contact for all compliance-related issues and inquiries regarding Medicaid dental insurance business.

Conduct training programs to educate staff on compliance-related matters, ensuring alignment with Medicaid requirements.

Investigate compliance issues and work with internal teams to resolve them in a timely manner.

Prepare and submit required reports to regulatory bodies and Medicaid authorities as needed.

Maintain knowledge of industry trends and best practices related to compliance in the Medicaid dental insurance space.

Develop corrective action plans and ensure compliance with Nevada state and federal guidelines during implementation.

Monitor Nevada state Medicaid Policies and Procedures (P&P) to ensure compliance with the Nevada state Medicaid contract.

Monitor and track high risk compliance issues which may expose LIBERTY to sanctions, penalties, liquidated damages, Corrective Action Plans (CAPs), and/or fines.

Monitor all Medicaid contractual commitments to ensure contractual obligations are met.

Oversee the onboarding and monitoring of all approved Medicaid subcontractors/vendors by National Compliance.

Collaborate with National Compliance regarding the responses to regulatory inquiries and regulatory audits which involve the Medicaid contract.

Track new requirements specific to the Medicaid Contract and provide guidance to business owners on existing and new Nevada state Medicaid requirements.

Collaborate with Corporate Compliance to investigate HIPAA, Privacy, and Security issues related to the Oklahoma Medicaid Contract.

Attend regulatory meetings as needed.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

MedicaidDHCFPMedicaid Program RequirementsHealthcare Compliance CertificationAudits ManagementRegulatory ReviewsCompliance ReportingLeadership Abilities

Required

Experience with DHCFP and expertise in Nevada Medicaid.

Bachelor's degree in Healthcare Administration, Law, Business, or a related field.

Minimum 6 years' experience in compliance roles, with a focus on Medicaid programs within the dental or healthcare insurance industry.

Comprehensive knowledge of Medicaid laws, regulations, and state-specific requirements.

Experience managing audits and regulatory reviews related to Medicaid services.

Excellent communication skills, with the ability to collaborate effectively across departments.

Strong problem-solving and analytical skills to handle complex compliance challenges.

Detailed knowledge of Medicaid program requirements, particularly DHCS, CMS, and other relevant Nevada state regulations.

Strong ability to assess compliance risks and propose mitigation strategies.

Excellent organizational skills and the ability to manage multiple priorities in a fast-paced environment.

Proficient in compliance-related reporting and documentation.

Leadership abilities to guide compliance efforts and foster a culture of adherence to regulations.

Preferred

Graduate degree.

Certification in healthcare compliance (CHC) or Certified Compliance and Ethics Professional (CCEP) preferred.

Benefits

Competitive pay structure and saving options that help you reach your financial goals

Excellent 401k retirement benefits available which includes employer match and ability to save via a Roth IRA, plus immediate vesting during Safe Harbor period and professional financial advice through Financial Engines!

Medical insurance offered with low-cost premium for employee only coverage and Liberty subsidizes 50% of dependent coverage for eligible enrolled dependents.

100% employer paid dental coverage for employees and eligible dependents.

100% employer paid vision coverage for employee only coverage, low-cost premium for dependents!

Company paid basic life and AD&D coverage; options to elect additional supplemental coverage.

Long Term Disability coverage

Expansive wellness program including companywide Get Active challenges and Burn-A-Long with option for gym discounts.

Employee Assistance Program

Generous vacation and sick leave with the ability to roll time over.

10 paid company holidays

Birthday flex holiday

Tuition Reimbursement

Remote or Hybrid options for various positions

And so much more...