Legal Advisor, Healthcare Regulatory Compliance
Core
Second line of defense Medicaid regulatory compliance audits and risk mitigation for EviCore's Medicaid program.
Role type
Senior Legal Compliance Advisor (Healthcare Regulatory)
Builds
Medicaid compliance programs and risk mitigation strategies
Domain
Healthcare / Managed Care / Medicaid
Required skills
Medicaid regulatory knowledge, compliance audit execution, risk assessment, corrective action oversight, cross-functional stakeholder management, regulatory interpretation, data analysis for compliance trends
Preferred skills
JD or Master's in healthcare, active RN license, clinical experience in managed care/utilization management, experience with Commercial/Medicare programs
Technologies
None explicitly stated
Responsibilities
Perform and oversee second line of defense Medicaid regulatory audits, ensure compliance with state and federal laws, provide day-to-day Medicaid regulatory guidance, notify stakeholders on updated contracts and regulations, present in regulatory oversight committees, identify compliance trends and risks, participate in client regulatory audits
Seniority
Senior, hands-on IC
