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Senior Consultant, Operations and Compliance

Job Summary:

Responsible for day to day management of internal operations to support a remote workforce in delivery of client services. This role will ensure that our business is well-coordinated and productive by managing its procedures and processes. Also responsible for providing subject matter expertise in a client facing role on Medicare and Compliance order to effectively support our clients.

Essential Functions:

  • Operations and Compliance
    • Act as company liaison for vendors including staffing agencies, Information Technology, and Human Resource Administration and establish relationships as needed for efficient operations.
    • In collaboration with Executive Team, develop and execute training plans and communication strategies for employee development, communication and education.
    • Update and maintain corporate policies and procedures including Employee Handbook, Disaster Recovery Plan and Corporate Compliance Plan.
    • Support scheduling function and client database updates and maintenance.
    • Screen candidates for hire, maintain job descriptions and reserve resumes.
    • Coordinate responses to IT Security surveys.
    • Review vendor and employment contracts for accuracy, completeness and risk mitigation.

    Part C, D and/or Compliance Subject Matter Expert

    • Provide subject matter expertise in designated areas of expertise
    • Provide review, interpretation and implementation of state and federal guidance
    • Perform CMS mock audits of areas by specialty
    • Perform operational remediation in areas of specialty
    • Mentor and drive work product based on the project scope of work
    • Develop, review for quality and coordinate all deliverables
    • Oversee and administer ongoing monitoring programs based on CMS guidance
    • Updates policies, procedures and project work plans as needed
    • Adhere to established corporate policies and procedures
    • Perform other duties, as necessary, to meet corporate objectives
    • Travel as required


  • Bachelor’s degree and a minimum of ten (10) years government, health care, pharmacy benefit management, compliance or quality profession (equivalent combination of education and experience considered.) Juris Doctorate preferred.
  • Extensive experience with Medicare Part C or D and Compliance operations
  • Experience with Medicare and/or Medicaid standards required
  • Advanced degree or certification in audit, law or compliance discipline preferred
  • Must have strong verbal and written communication skills
  • Ability to maintain positive business relationships to ensure future sales
  • Excellent skills in influence, negotiation and closing sales.
  • Individual should be detail oriented with strong organization, prioritization and analytical skills with the ability to work independently.
  • Must work well under tight timelines and adapt quickly to change in a fast-paced, team-oriented, and high-growth environment.
  • Must have strong Microsoft Office Suite skills, Advanced skills in Word, Excel, Access and PowerPoint required


Senior Consultant, Operations and Compliance

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