Risk, Compliance, and Governance Domain Senior Manager

As a Risk, Compliance, and Governance Domain Senior Manager, you will have the opportunity to help our clients mitigate risks related to health care fraud, waste, and abuse, as well as to improve their ability to meet regulatory requirements, expectations, and guidance in support of developing and maintaining sound program integrity and compliance programs and controls. You will build your professional skills in a variety of project experiences by assisting our clients to understand the complexities of the issues they face, and by implementing solutions to help them remediate identified issues.

• Provide regulatory, operational and technology insights in health care fraud-related topics (e.g., Medicare/Medicaid program integrity, False Claims Act, Anti-Kickback Statute, and Stark Law compliance).
• Analyze and optimize Fraud, Waste, and Abuse (FWA) compliance processes, systems, and technology.
• Develop and implement corrective action plans for the resolution of issues and provide guidance on how to avoid or deal with similar situations in the future.
• Keep abreast of regulatory developments both within and outside of the company, as well as evolving best practices in health care program integrity, fraud, compliance, and enforcement.
• Prepare and present clear and concise presentations, reports, and proposals to senior leaders, and government officials; both at our clients and within Deloitte.
• Lead, plan, and manage projects, including writing proposals, defining scope, overseeing fieldwork, and preparing deliverables, ensuring that a high-quality integrated service is provided on time.
• Leading and mentoring professional teams on projects.
• Develop and coach team members.
• Assessing health care fraud and program integrity risks at the enterprise and business unit level.
• Overseeing large-scale programs including claims data analytics reviews, provider screening, compliance program assessments, and investigations.

A successful candidate would possess these skills:

• Ability to work independently and collaborate as part of a team.
• Effective written and verbal communication skills.
• Meticulous attention to detail and quality of work product.
• Ability to build and sustain professional relationships.
• Ability to lead projects or workstreams.
• Ability to manage and prioritize multiple tasks in a fast-paced and dynamic environment.
• Strong interpersonal skills and professional demeanor.
• Ability to meet deadlines.
• Ability to mentor and provide clear guidance to others.

• Bachelor's degree
• 10+ years of experience in federal, state, or private-sector health care fraud investigations, compliance, or program integrity activities, including management experience.
• 10+ years of experience in health care fraud detection, data analytics, and case management systems and related software.
• Subject matter expertise in health care fraud, waste, and abuse laws and regulations as they apply to Medicare, Medicaid, and other federal and state health care programs.
• Experience leading and managing multidisciplinary teams of investigative, analytical, and/or compliance professionals.
• Must be able to obtain and maintain the required clearance for this role.
• Ability to travel 25-75%, on average, based on the work you do and the clients and industries/sectors you serve.
• Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future.

Preferred:

• Ability to provide advice regarding applicable health care fraud regulations and requirements to stakeholders on regulatory, operational, and documentation issues.
• Experience submitting written and oral reports to senior stakeholders or clients.
• Excellent written and verbal communication skills.
• Strong analytical and investigative skills.
• Strong attention to detail and organizational skills.
• Proven experience effectively prioritizing workload, managing multiple priorities, and quickly adapting to meet deadlines and work objectives.

For individuals assigned and/or hired to work in Arlington, VA, Deloitte is required by law to include a reasonable estimate of the compensation range for this role. This compensation range is specific to Arlington, VA and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $184,100 to $306,800.

You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance.

Deloitte is committed to providing reasonable accommodations for people with disabilities. If you require a reasonable accommodation to participate in the recruiting process, please direct your inquiries to the Global Call Center (GCC) at USTalentCICInbox@deloitte.com.