Medicaid Compliance Manager

Job Posting Title

Medicaid Compliance Manager

Agency

807 HEALTH CARE AUTHORITY

Supervisory Organization

Program Integrity & Account

Job Posting End Date (Continuous if Blank)

April 24, 2025

Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above.

Estimated Appointment End Date (Continuous if Blank)

Full/Part-Time

Full time

Job Type

Regular

Compensation

Based on education and experience.

Job Description

Agency/Division Information

The Oklahoma Health Care Authority (OHCA) works to ensure Oklahomans have access to better health and better care. The agency’s core values include passion for purpose, trust and transparency, empowerment and accountability, best in class and outcome-driven, and servant leadership. As part of the interview process, candidates may be required to attend an in-person interview at our Oklahoma City office.

Position Purpose

The Medicaid Compliance Manager is responsible for ensuring regulatory adherence, ethical standards, and compliance program effectiveness across the organization. This role oversees compliance initiatives, policy development, and risk management strategies to maintain operational integrity. The Medicaid Compliance Manager works collaboratively with internal and external stakeholders to foster a culture of compliance while adapting to evolving laws, regulations, and industry standards.

Principle Activities May Include

• Develop, implement, and maintain compliance policies and procedures to align with federal, state, and industry regulations.

• Conduct ongoing regulatory monitoring to ensure policies remain up to date.

• Provide guidance on compliance-related matters, including policy interpretation and application.

• Anticipate regulatory changes and proactively recommend compliance solutions that align with business objectives.

• Oversee compliance audits, risk assessments, and incident investigations, identifying gaps and recommending corrective actions.

• Manage the response process for compliance violations, including documentation, reporting, and resolution tracking.

• Identify opportunities for process improvements in compliance monitoring, reporting, and enforcement.

• Stay informed on regulatory trends and emerging risks, recommending proactive compliance measures.

• Develop action plans to address compliance gaps and enhance operational efficiency.

• Develop and deliver compliance training programs for employees at all levels.

• Serve as a subject matter expert for compliance-related inquiries and training initiatives.

• Promote a culture of compliance through proactive education, engagement, and ethical decision-making across departments.

• Ensure adherence to data protection regulations such as HIPAA, GDPR, or other applicable privacy laws.

• Work closely with IT and security teams to implement data security best practices and incident response protocols.

• Act as a liaison between the organization and regulatory bodies, ensuring timely reporting and compliance updates.

• Provide compliance updates to leadership and contribute to strategic planning discussions.

• Prepare reports and presentations for executive leadership, board members, and regulatory agencies as needed.

• Build strong relationships with internal and external partners to foster compliance integration within organizational processes.

• Identify trends and emerging compliance risks, driving enhancements to existing compliance programs.

• Act as a compliance champion, influencing organizational policies and promoting regulatory adherence.

• Other duties as assigned.

Supervisory Responsibilities: This position may have supervisory responsibilities.

Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

Knowledge, Skills, Abilities and Competencies

The Medicaid Compliance Manager must possess a deep understanding of federal, state, and industry compliance regulations, including but not limited to Medicaid and Managed Care rules and regulations in addition to privacy laws, risk management principles, and corporate ethics. Success in this role requires strong analytical and problem-solving abilities to assess risks and implement effective compliance measures. The ability to communicate complex regulatory concepts in a clear and practical manner is essential, as this role involves engaging with stakeholders across various departments. The ideal candidate is a proactive thinker with a strategic mindset, capable of learning and navigating complex regulatory landscapes and adapting compliance strategies to align with business objectives. A collaborative approach is crucial, as the Medicaid Compliance Manager works closely with legal, finance, HR, IT, and external regulatory agencies to ensure compliance integration. Korn Ferry competencies such as Ensures Accountability, Strategic Mindset, Manages Complexity, and Collaborates are critical in driving compliance initiatives, mitigating risks, and fostering a culture of ethical governance within the organization.

Education and/or Experience:

• Bachelor’s degree AND 4 years of professional experience OR

• An equivalent combination of education and experience, substituting one year of professional experience for each year of the required education.

Preference may be given to candidates with

• Advanced education in business administration, public administration, or law

• Experience in compliance, risk management, or business/public administration.

• Experience in legal, policy, or regulatory compliance, particularly in HIPAA, ADA, public disclosure laws, civil rights, and information governance.

• Experience with regulatory or compliance in Medicaid or Managed Care.

• Strong risk management experience, including handling external audits, internal controls, and regulatory compliance.

• Experience managing litigation or working closely with legal teams and government agencies, such as attorneys general offices.

• Certifications in any of the following areas: Certified Information Privacy Manager (CIPM), Certified Information Privacy Professional (CIPP), Certified Information Privacy Technologist (CIPT), Certified Risk Manager (CRM), Certified Risk Management Professional, COSO ERM Certificate, Artificial Intelligence Governance Professional (AIGP)

• License to practice law in the State of Oklahoma and membership in Oklahoma Bar Association.

Physical Demands

• Must be able to remain sitting for prolonged periods at a desk and working on a computer.

• Must be able to move or lift up to 15 pounds at various times.

Work Environment

The office work environment includes regular exposure to general office equipment such as computer equipment, phones, and copy machines. 

Why You’ll Love Working Here

At the Oklahoma Health Care Authority (OHCA), we’re proud to create a workplace where employees thrive. Named a Top Workplace in Oklahoma for five consecutive years, this achievement reflects the dedication and collaborative spirit of our incredible team. Here's what we offer to support employees and their family:

• Generous state-paid benefit allowance to offset insurance premiums.

• A wide selection of top-tier health insurance plans.

• Optional flexible spending accounts for health care or dependent care expenses.

• Employee Assistance Program (EAP) offering confidential support.

• Wellness benefits, including an on-site gym and fitness center discounts.

• 11 paid holidays annually.

• 15 vacation days and 15 sick days in your first year.

• Retirement Savings Plan with substantial employer contributions.

• Longevity Bonus to reward years of service.

• Public Service Loan Forgiveness eligibility and reimbursement for educational expenses.

• Professional development training opportunities, including CEU support.

Accommodation Statement:

The Oklahoma Health Care Authority complies with applicable State and Federal civil rights laws and does not discriminate.  All qualified applicants will receive consideration for employment without regard to race, color, sex, religion, disability, age, national origin, or genetic information. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact the Civil Rights Coordinator at 405-522-7335. 

Notice to applicants:

Please add OHCAHR@okhca.org  to the address book or “safe-senders” list in your email.  All correspondence will come from this address.  Be sure to check your junk folder.  If you have questions about the status of your application, you can contact the HR team at 405-522-7093.

Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above.

Current State of Oklahoma employees must apply for open positions internally through Workday Jobs Hub. 

Equal Opportunity Employment

The State of Oklahoma is an equal opportunity employer and does not discriminate on the basis of genetic information, race, religion, color, sex, age, national origin, or disability.

Current active State of Oklahoma employees must apply for open positions internally through the Workday Jobs Hub.