Lead Nurse Consultant

Internships(1 month ago)

HybridFull TimeSenior$64,211 - $105,949Health Benefits (Medicaid)

About this role

A senior-level clinical and investigative consultant within the North Carolina Medicaid Office of Compliance and Program Integrity (OCPI). The role applies advanced clinical judgment and regulatory expertise to support Medicaid program integrity and ensure payments align with state and federal policy. The position partners with internal teams and external vendors to inform data-driven decisions and maintain compliance.

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Required Skills

Payment Analytics
Clinical Audit
Claims Review
Investigations
Appeals Management
Vendor Management
Policy Interpretation
Clinical Consultation
Case Documentation
Process Improvement

+2 more

Qualifications

Licensed Registered Nurse - North Carolina
2 Years Clinical Experience

About Internships

pa.gov

The Commonwealth of Pennsylvania (pa.gov) is the official state government portal that centralizes access to services, news, and information for residents, businesses, and visitors. It links users to hundreds of agencies and programs—covering benefits, licensing and permits, taxes, public safety, health resources, employment, and more—along with forms, publications, and contact details. The site provides online tools for transactions (renewals, payments, applications) and delivers updates on public policy, emergency alerts, and state initiatives. Designed for accessibility and ease of use, pa.gov aims to streamline interactions with government and improve transparency across the Commonwealth.

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