Compliance Lead (Healthcare Medicaid)

Location: Louisville, Kentucky; only applicants residing in Kentucky within 180 miles of Frankfort. Must be available to meet regulators at a location in Kentucky with 24 hours' notice.

Salary: $115,200–$158,400 per year, plus eligibility for a bonus incentive plan.

Company

hirify.global is a U.S. healthcare company providing insurance and healthcare services to people with Medicare and Medicaid, families, individuals, military personnel, and communities.

What you will do

• Serve as the dedicated Regulatory Compliance Officer for the Kentucky Medicaid contract.
• Build relationships with market leadership, external regulators, business partners, and oversight agencies.
• Oversee Medicaid operations from readiness review through contract duration to minimize compliance risk.
• Conduct risk assessments, develop annual compliance audit and monitoring plans, and oversee corrective action and remediation activities.
• Interpret state and federal regulations and contract requirements, review evidence, and provide guidance to hirify.global departments and external partners.
• Manage external audits, compliance reporting, data analytics, the Kentucky Compliance Committee, and fraud, waste, and abuse program integrity activities.

Requirements

• Bachelor's degree in a related field.
• 7+ years of advanced experience in compliance, managed care, or Medicaid.
• 3+ years interpreting and providing guidance on healthcare regulations and compliance requirements.
• 3+ years analyzing and reviewing metrics related to contract compliance.
• Clear, professional, and impactful communication skills across internal and external stakeholder groups.
• Must reside in Kentucky within 180 miles of Frankfort and be available to meet regulators in the Commonwealth with 24 hours' notice.

Nice to have

• Juris Doctor or another advanced degree.
• Audit experience and experience with metrics and reporting.
• Experience working with regulatory agencies, including state departments of health insurance or CMS.

Culture & Benefits

• Full-time schedule of 40 hours per week.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off, company and personal holidays, and paid parental and caregiver leave.
• Short- and long-term disability, life insurance, and other wellness benefits.