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Responsibilities:

• Lead a cross-functional model team in the design and development of the compliance strategy, monitoring and auditing plan, risk framework and remedial action plan

• Lead and coordinate the implementation of compliance and audit activities, sampling, and preparation of audit materials

• Ensure timely communication and responsiveness to issues, tracking to resolution

• Identify and track risks and negative trends on non-compliance, and fraud, waste, and abuse activities; propose or implement necessary recommendations or remedial action

• Provide guidance to the data analytics team, including creation of a project dashboard

• Participate in compliance remediation plan development and implementation

• Lead audit documentations, audit preparations, audit report development

• Communicate routinely with CMS and other stakeholders, including leading and facilitating standing model meetings across internal and external stakeholders

Requirements:

• Bachelor's degree in law, accounting, economics, or related field

• 5+ years of?experience developing and implementing compliance programs or audit activities or leading large projects or programs

• Ability to lead a multi-disciplined, cross-organizational team of subject matter experts

• Program and policy knowledge in payment models, value-based experience or understanding of compliance and monitoring preferred

• Experienced in leading, planning, coordinating, directing, and overseeing projects and teams

• Experience with compliance/monitoring, and auditing initiatives for the CMS Innovation Center Models, Primary Care Models, and Accountable Care organizations

• Knowledge of healthcare industry and systems, claims processing, Medicare preferred

• Previous experience working with the Center for Medicare and Medicaid 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

• Significant experience using Microsoft Applications: Word, Excel, Access, and PowerPoint. Experience working with Tableau or other BI tools preferred

EEO Employer:

RELI Group is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.

HUBZone:

RELI Group is an established SBA certified HUBZone (https://www.sba.gov/federal-contracting/contracting-assistance-programs/hubzone-program) and 8(a) small business (https://www.sba.gov/federal-contracting/contracting-assistance-programs/8a-business-development-program) . We encourage all candidates who live in a HUBZone to apply. You can check to see if you address is located in a HUBZone by accessing the SBA HUBZone Map (https://maps.certify.sba.gov/hubzone/map#center=39.828200,-98.579500&zoom=5) .