SME - Medicaid Program Integrity and Claims Audits

Job description

Overview BerryDunn is seeking a Senior Consultant with subject matter expertise in Medicaid program integrity and claims audits to assist clients with prevention and detection of fraud, waste, and abuse. This individual will be responsible for assisting with risk assessment, external audit coordination, interpretation and application of Medicaid policy and applicable code of federal regulations, and conducting Medicaid medical, dental, behavioral health, and pharmacy claims audits. You will work remotely, hybrid, or in one of our offices, mainly helping client in Guam. You will report to and partner with Government Assurance Practice Group management team members for both client work and career development. With a growth mindset, you will drive your own development with support from our management team. Travel Expectations: Travel to client sites can range up to 50%. You Will: - Establish and monitor Medicaid program integrity objectives, and key performance indicators (KPIs). - Ensure the Medicaid program integrity policies and procedures meet federal and state policies and grants compliance. - Research Medicaid policies and regulations. - Advise and assist clients in translating...