Health Care Compliance Investigator, Senior Manager (Remote)

Aledade is recruiting for a Compliance Investigator who will be responsible for enhancing the compliance investigations function by transforming it into a data-driven, risk based program.  

This position involves oversight and management of the compliance investigations function.  This individual will be responsible for (1) establishing an Investigations Protocol with timing metrics to ensure responsiveness, (2) promptly conducting confidential, as well as privileged investigations into potential compliance violations, (3) analyzing data to identify trends, and (4) providing recommendations for corrective actions.

We are flexible with respect to geographic location, and the ideal candidate will be comfortable working remotely/work from home within the U.S. or from our headquarters office in Bethesda, MD.

• Maintain an investigation policy and protocol.
• Lead/Conduct thorough investigations into allegations of compliance violations, including but not limited to Fraud, Waste, and Abuse, Conflict of Interest, Anti-Kickback Statute (AKS), and other policy breaches. 
• Interview relevant personnel and examine documentation to assess compliance with laws, regulations, and company policies.
• Collect, analyze, and interpret complex data related to compliance issues in order to identify trends and areas of improvement.
• Prepare detailed reports outlining findings, conclusions, and recommendations for corrective actions or enhancements to the compliance program.
• Report on material investigation finding to the Compliance Committee and the Board of Directors

• Bachelor’s degree.
• 8 years of compliance experience; minimum 5 years of experience working in a health care organization and/or role. 
• Proven experience in a compliance investigator role within the health care industry, preferably in a technology-focused environment.
• Excellent written and verbal communication skills, with the ability to present complex information clearly and concisely.
• Strong understanding of health care regulations, including HIPAA, Stark Law, Anti-Kickback Statute, and other relevant regulations. 

• 2 years of direct, indirect and/or cross functional experience leading teams.
• Experience with health care billing and coding. 
• Certified in Health care Compliance.  

Who We Are:

Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of payers, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives, and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.

What Does This Mean for You?

At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.

In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:

Flexible work schedules and the ability to work remotely are available for many roles

Health, dental and vision insurance paid up to 80% for employees, dependents, and domestic partners Robust time off plan 21 days of PTO in your first year 2 Paid Volunteer Days & 11 paid holidays

12 weeks paid Parental Leave for all new parents

6 weeks paid sabbatical after 6 years of service

Educational Assistant Program & Clinical Employee Reimbursement Program

401(K) with up to 4% match

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And much more!

At Aledade, we don’t just accept differences, we celebrate them!   We strive to attract, develop, and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance, and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.

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