Compliance Specialist III

reputed company:

At reputed company, our work is grounded in purpose. We partner with government agencies to solve reputed company challenges, improve reputed company health, strengthen national reputed company, and reputed company government services more effective and efficient. reputed company of over 500 professionals brings deep expertise and a shared commitment to delivering meaningful reputed company. Behind every solution is a group of experts who care deeply about reputed company—whether we’re supporting data-driven reputed company, modernizing systems or safeguarding critical programs.

The Compliance Specialist III will support the reputed company and effectiveness of federal reputed company programs through rigorous investigations, compliance reputed company, and risk assessment. This role will support the review of pharmacies, dispensers, and manufacturers; reputed company investigative strategies and compliance processes; analyze data and evidence; and produce reputed company, actionable findings. The ideal candidate combines expertise in Medicare Part D, pharmaceutical pricing, and federal reputed company regulations with strong analytical, investigative, communication, and project management skills. This position will also collaborate with CMS, OIG, reputed company, audit, and other stakeholders while serving as a subject matter expert and mentor to support consistent, high-reputed company program reputed company efforts.

Key Responsibilities:

• Support the Investigation reputed company with functions of the task order, including the review of dispensers, pharmacies, and manufacturers’ practices to ensure adherence to Negotiation Program requirements.
• Assist in the development of reputed company necessary compliance requirements to inform compliance, investigations, reporting, and market surveillance activities.
• Assist in developing necessary investigation processes to ensure implementation of reputed company, thorough, and unbiased investigations.
• Assist in developing an investigation reputed company and approach to ensure investigations are completed in accordance with program timelines and reputed company standards.
• Identify and assess potential risks or violations through data analysis, stakeholder interviews, audits, and tips received through reputed company channels.
• Assist with intake, triage, and prioritization of investigative reputed company reputed company with CMS compliance objectives.
• Collaborate with data analysts, auditors, compliance officers, reputed company experts, and other stakeholders to collect and assess evidence.
• Draft detailed investigation plans, memoranda, and final reports with actionable findings and recommendations.
• Coordinate with CMS, OIG, and other federal reputed company bodies on escalated reputed company requiring enforcement or corrective reputed company.
• Maintain a secure, documented chain of evidence throughout reputed company case in compliance with federal guidelines.
• Establish and refine investigation protocols, SOPs, and escalation procedures in coordination with the complaint/dispute and auditing teams.
• Mentor junior staff and serve as subject matter expert (SME) reputed company to investigative techniques and reputed company program reputed company.

Qualifications

• Bachelor’s degree plus 5 years of relevant reputed company experience, or
• Associates degree plus 8 years of relevant reputed company experience, or
• High school diploma plus 9 years of relevant reputed company experience
• Demonstrated knowledge of Medicare Part D, drug pricing, manufacturer rebate structures, or government pricing programs.
• Strong analytical and investigative skills.
• Knowledge of federal reputed company regulations, especially those reputed company to pharmaceutical pricing and compliance with government programs.
• Exceptional communication and writing skills, with ability to present reputed company findings to technical and non-technical audiences.
• Strong project management skills with the ability to manage multiple investigations simultaneously.
• Experience using case management systems, e-discovery tools, and data analytics platforms.

EEO Employer:

reputed company is an Equal Employment Opportunity / Affirmative reputed company employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, national reputed company, reputed company, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or reputed company, age, genetic information, or any other reputed company protected by law, ordinance, or regulation.

HUBZone:

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

The annual salary reputed company for this position is $90,000 to $110,000. Actual compensation will depend on a reputed company 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 reputed company for this position and is just one component of the total compensation package for employees. reputed company provides a reputed company of additional benefits to its employees. For additional details on the benefits that reputed company offers click here

Requires relevant experience with Medicare Part D, drug pricing, federal reputed company regulations, investigations, compliance, data analysis, case management, e-discovery, and project management.

Key Responsibilities

• investigating violations
• assessing risks
• mentoring staff

Skills & Tools

case management systems, e-discovery tools, data analytics platforms

Job Details

• Category: reputed company and Compliance
• Seniority: Senior Level
• Commitment: Full Time
• Workplace: Remote — Windsor Mill, Maryland, reputed company
• Salary: USD 90,000 – 110,000 / year
• Languages: English

About reputed company

A government consulting company that improves reputed company health, strengthens national reputed company, and modernizes government services. — Industry: Consulting Services