Lead Medicaid program integrity activities, including fraud, waste, and abuse prevention, provider oversight, compliance monitoring, risk assessment, and audit coordination.
Stand up and stabilize Program Integrity unit functions, including foundational processes, operating rhythms, documentation, and quality controls.
Review and audit Medicaid claims for accuracy, legality, and alignment with policies and regulations.
BerryDunn is a client-centered, people-first professional services firm that helps businesses, nonprofits, and government agencies solve challenges since 1974. The firm is recognized for its inclusive culture, learning, and development focus, led by CEO Sarah Belliveau.
Lead one or more client policy initiatives with a team, including policy analysis, client communications, and project tracking.
Drive your development through an annual growth process in partnership with your supervisor and the learning and development team.
Participate in new business development through research, proposal content, and marketing materials.
BerryDunn is a professional services firm that has helped businesses, nonprofits, and government agencies since 1974. The firm is client-centered and people-first, with a focus on learning, development, and well-being, and has been recognized for its diverse and inclusive workplace culture.
Coordinates and administers privacy and compliance programs to ensure adherence to regulatory requirements.
Partners with internal teams to interpret requirements, implement compliant solutions, and monitor activities.
Develops policies, tracks corrective actions, and supports audits to maintain program effectiveness.
Capital Blue Cross is a health insurance company that improves the health and well-being of members and communities. It is an independent licensee of the Blue Cross Blue Shield Association and has been voted a 'Best Place to Work in PA' by employees.
Support implementation and operation of the Compliance Program, including conflict of interest, compliance hotline, and regulatory reviews.
Serve as liaison for compliance questions and incidents, and recommend corrective actions and education opportunities.
Work with all levels to ensure internal controls provide accurate, complete, and compliant processes.
Cooper University Health Care is a healthcare organization dedicated to providing extraordinary health care and fostering clinical innovation. It offers competitive compensation, comprehensive benefits, and opportunities for professional growth.
Collaborate with business stakeholders to perform root cause analysis.
Develop job aids, playbook, and other program documentation.
SmithRx is a Health-Tech company disrupting the Pharmacy Benefit Management industry with a technology-driven platform. The venture-backed company has hundreds of thousands of members and fosters a collaborative, mission-driven culture.
Oversee hospice intake compliance and execute clinical audit activities across the organization.
Conduct pre-bill chart audits to ensure Medicare regulatory compliance and documentation accuracy.
Collaborate with clinical and operational teams to strengthen audit readiness and support revenue cycle efficiency.
Ennoble Care is a mobile primary care, palliative care, and hospice service provider operating across multiple states. The company prioritizes high-quality care for chronic conditions and limited mobility, embodying the motto "To Care is an Honor."
Lead and support Medicaid Enterprise System initiatives, including system modernization, vendor oversight, and program advisory for U.S. territory and state agencies.
Manage complex multi-stakeholder environments, including government entities, system integrators, and federal partners, ensuring delivery quality and stakeholder alignment.
Provide subject matter expertise in Medicaid domains such as eligibility, enrollment, claims, and financial management, and contribute to key deliverables like ConOps and APDs.
BerryDunn is a client-centered, people-first professional services firm providing tax, advisory, and consulting services to businesses, nonprofits, and government agencies. Since 1974, they have grown to serve clients throughout the US and its territories, led by CEO Sarah Belliveau and recognized for their inclusive workplace culture and focus on learning and well-being.