Job description
Responsibilities:
- Design and develop audit methodology for CMS programs and execute audits
- Responsible for planning, conducting and or leading a range of audits and compliance reviews
- Oversee and manage multiple concurrent audits ensuring quality work product is delivered that stands up to regulatory review and that the work is completed on-time and on-budget
- Responsible for planning, executing, and providing supporting documentation to facilitate review activities using a systematic approach to achieve the desired goals
- Develop various reports of audit procedures and findings, communicate findings with clients as appropriate
- Develop standard tools and procedures to improve audit efficiency, identify areas of improvements, determine audit requirements
- Perform high quality compliance reviews and audits while using the Lean-Agile transformation skills where applicable
- Monitor for risks, Fraud, Waste and Abuse and address them before they become issues, propose remedial action as needed and track the responses to remedial actions
- Perform concurrent high quality compliance reviews and audits in accordance with established processes and standards
- Communicate proactively and respond to timely requests
- Adhere to internal and client approved timelines
Requirements:
- 5+ years of experience developing and implementing compliance programs or audit activities or leading large projects or programs
- Program and policy knowledge in payment models, value-based experience or understanding of compliance and monitoring preferred
- 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
- Experience working among large and complex team with proven collaborative skills
- 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
- Ability to manage multiple tasks and deliverables concurrently while maintaining quality and established timelines
- Ability to draft reports and documents that include analysis as well reporting of findings
- Ability to initiate novel tasks and activities
- Ability to perform in a fast-paced, dynamic environment
- Bachelor's degree required - Law, accounting, economics, or related field.
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 and 8(a) small business. 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.
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