Senior Compliance Specialist

Description

• Lead or support in the planning, development, implementation, and maintenance of the compliance strategy, monitoring and auditing program/plan, risk framework, and remedial action plan.
• Conduct ad hoc and ongoing risk assessments and propose risk mitigation strategy as appropriate. Assist with tracking risks and trends on a routine basis.
• Lead or coordinate the implementation of compliance and audit activities, sampling, auditing/monitoring schedules, development of various audit trackers, and preparation of audit materials/documentation.
• Lead various monitoring and auditing activities including scheduled or ad hoc audits; develop audit reports and propose and implement remedial actions.
• Analyze results, identify trends or patterns, and propose risk mitigations or recommendations and implement proposed recommendations to address compliance or program integrity risks.
• Develop, maintain, and update Standard Operating Procedures and auditing and monitoring plans.
• Lead or assist with drafting responses to inquiries for compliance related matters.
• Ensure timely communication and responsiveness to issues, propose recommendations, and track resolution.
• Communicate routinely with CMS and other external as well as internal stakeholders.
• Conduct or participate in meetings and present findings and outcomes of the various activities as appropriate.

Qualifications

• Education: BS required - Bachelor's degree in business, accounting, economics, healthcare management, or related field.
• Experience: 5 years of experience developing and implementing compliance programs or audit activities or leading large projects or programs.
• Experience with compliance/monitoring, and auditing initiatives for the CMS Innovation Center Models, Primary Care Models, and Accountable Care organizations.
• Ability to lead a multi-disciplined, cross-organizational team of subject matter experts.
• Knowledge of healthcare industry and systems, claims processing, Medicare preferred.
• Experienced in planning, coordinating, directing, and overseeing projects and teams.
• Previous experience working with the Centers for Medicare and Medicaid Services (CMS) preferred.
• Program and policy knowledge in payment models, value-based care experience or understanding of compliance and monitoring preferred.
• Strong analytical and problem-solving skills; critical thinking skills; strong stakeholder management and meeting management skills.
• Outstanding written and verbal communication skills; ability to communicate and facilitate communication with individuals at various levels within the organization and external clients in a leadership capacity.
• Ability to multitask and participate in or lead various concurrent workstreams.
• Ability to thrive in a fast-paced environment and agility to respond to quick turnaround ad hoc client requests.
• Significant experience using Microsoft Applications: Word, Excel, and PowerPoint.

EEO Employer:

RELI Group is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.

HUBZone:

We encourage all candidates who live in a HUBZone to apply. You can check to see if your address is located in a HUBZone by accessing the SBA HUBZone Map.

The annual salary range for this position is $90,000.00 to $120,000.00. Actual compensation will depend on a range of factors, including but not limited to the individual’s skills, experience, qualifications, certifications, location, other business and organizational needs, and applicable employment laws. The estimate displayed represents the typical salary range for this position and is just one component of the total compensation package for employees. RELI Group provides a variety of additional benefits to its employees. For additional details on the benefits that RELI Group offers click here

Salary : $90,000 - $120,000