Health Industries Provider Research & Compliance Manager

Pwc Jacksonville , FL 32277

Posted 2 months ago

A career within Internal Audit services, will provide you with an opportunity to gain an understanding of an organisation's objectives, regulatory and risk management environment, and the diverse needs of their critical stakeholders. We focus on helping organisations look deeper and see further considering areas like culture and behaviours to help improve and embed controls. In short, we seek to address the right risks and ultimately add value to their organisation.

To really stand out and make us fit for the future in a constantly changing world, each and every one of us at PwC needs to be a purpose-led and values-driven leader at every level. To help us achieve this we have the PwC Professional; our global leadership development framework. It gives us a single set of expectations across our lines, geographies and career paths, and provides transparency on the skills we need as individuals to be successful and progress in our careers, now and in the future.

As a Manager, you'll work as part of a team of problem solvers, helping to solve complex business issues from strategy to execution. PwC Professional skills and responsibilities for this management level include but are not limited to:

  • Develop new skills outside of comfort zone.

  • Act to resolve issues which prevent the team working effectively.

  • Coach others, recognise their strengths, and encourage them to take ownership of their personal development.

  • Analyse complex ideas or proposals and build a range of meaningful recommendations.

  • Use multiple sources of information including broader stakeholder views to develop solutions and recommendations.

  • Address sub-standard work or work that does not meet firm's/client's expectations.

  • Use data and insights to inform conclusions and support decision-making.

  • Develop a point of view on key global trends, and how they impact clients.

  • Manage a variety of viewpoints to build consensus and create positive outcomes for all parties.

  • Simplify complex messages, highlighting and summarising key points.

  • Uphold the firm's code of ethics and business conduct.

Job Requirements and Preferences:

Basic Qualifications:

Minimum Degree Required:

Bachelor Degree

Minimum Years of Experience:

5 year(s)

Preferred Qualifications:

Preferred Fields of Study:

Business Administration/Management, Health Administration

Certification(s) Preferred:

Certified in Healthcare Compliance (CHC), Certified Health Privacy Compliance (CHPC), Certified Compliance & Ethics Professional (CCEP), Certified Internal Auditor (CIA), Certified Public Accountant (CPA)

Preferred Knowledge/Skills:

Demonstrates extensive abilities and/or a proven record of success as a team leader in roles involving healthcare compliance, either directly in industry or with a professional services firm, including in the following areas:

  • Leading auditing and monitoring projects to address specific healthcare compliance risks;

  • Following up on corrective actions in response to identified issues and audits;

  • Developing healthcare compliance policies and procedures, emphasizing prior success in roles identifying and remediating compliance deficiencies;

  • Understanding of the key compliance and regulatory risks in a provider environment;

  • Exhibiting familiarity with healthcare compliance regulatory agencies and a general understanding of healthcare laws and regulations (e.g., HIPAA, CMS, OIG, OCR, Medicare, Medicaid, Affordable Care Act, Stark/Anti-Kickback, Fraud, Waste and Abuse, False Claims Act, Accreditation, Research and Academic Medical Center experiences); and,

  • Managing, leading and evaluating professional staff.

Demonstrates extensive-level abilities, with success managing the identification and addressing of client needs: in managing client engagements related to directing and implementing ethics and compliance programs within the healthcare industries, either in industry or for a professional services firm, including the following:

  • Assisting on business development opportunities and/or engagements from pre-sale and initial scoping through final delivery and signoff;

  • Utilizing consistent creative problem-solving abilities and consultancy mindsets while working on, as well as researching, problems and/or issues and developing effective solutions for, clients' healthcare compliance activities;

  • Conducting audits across compliance areas (drug diversion, physician arrangements, conflict of interest, etc.);

  • Identifying and addressing client needs, building relationships with clients, developing an awareness of firm services, approaching client in an organized and knowledgeable manner, delivering clear requests for information, and demonstrating flexibility in prioritizing and completing tasks;

  • Demonstrating knowledge of tech enabled solutions (visualization, analytics, RPA) and approaches;

  • Maintaining relationships and building credibility with companies and professional affiliations, organizations or networks within healthcare, ethics and compliance;

  • Conducting analyses that leverage creative and critical thinking and problem solving, as well as utilize consensus building skills to derive solutions through, utilizing information systems, databases, Excel and Microsoft Word,

  • Developing strategy as well as writing, communicating, facilitating, and presenting cogently to and/or for all levels of industry audiences, clients and internal staff and management;

  • Budgeting and forecasting on large engagements;

  • Leading teams, supervising teams to create an atmosphere of trust, seeking diverse views to encourage improvement and innovation, participating in various staff recruitment and retention activities, and coaching staff including providing timely meaningful written and verbal feedback; and,

  • Demonstrating flexibility and desire to travel, as client assignments require.

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Health Industries Provider Research & Compliance Manager

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