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 actions
• 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 develop audit methodology for CMS programs and execute audits
• Perform review of various materials, maintain and update various trackers and timelines
• Update the processes and procedures as needed by discussing with PM/PD
• Develop agenda, lead internal and external meetings

Requirements:

• Education: BS of higher degree required- Law, Healthcare Administration, Public Health accounting, economics, or related field
• Experience: 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. Experience 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
• 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
• Prior CMS/CMMI monitoring compliance experience

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

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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