Managed Care Compliance, Senior Associate

Specialty/Competency: Business Controls

Industry/Sector: Pharma and Life Sciences

Time Type: Full time

Travel Requirements: Up to 60%

A career in our Regulatory Compliance practice, within Risk and Compliance services, will provide you the opportunity to work with a team that provides clients with extensive risk and controls technical knowledge and sector specific experience. You’ll have the opportunity to develop a holistic approach to risk that protects businesses, facilitates strategic decision making and enhances efficiency by assisting management in the assessment of project risks and controls. Our team works with clients to understand and address enterprise risk, the regulatory landscape and the client’s regulatory profile. You’ll help clients improve and operate solutions to manage risk and monitor compliance as well as keep informed on changes in the regulatory landscape that assist our clients in maintaining compliance.

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.

Responsibilities

As a Senior Associate, 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:

• Use feedback and reflection to develop self awareness, personal strengths and address development areas.
• Delegate to others to provide stretch opportunities, coaching them to deliver results.
• Demonstrate critical thinking and the ability to bring order to unstructured problems.
• Use a broad range of tools and techniques to extract insights from current industry or sector trends.
• Review your work and that of others for quality, accuracy and relevance.
• Know how and when to use tools available for a given situation and can explain the reasons for this choice.
• Seek and embrace opportunities which give exposure to different situations, environments and perspectives.
• Use straightforward communication, in a structured way, when influencing and connecting with others.
• Able to read situations and modify behavior to build quality relationships.
• Uphold the firm's code of ethics and business conduct.
  
  

Healthcare Compliance professionals help clients meet regulatory requirements and respond to regulatory actions through assessments, design frameworks and controls, embed tech enabled solutions and implementation. They work with clients to understand their regulatory environment, apply regulatory standards, prepare them for regulatory exams, develop responses to regulators to help clients remain compliant with regulations.

Basic Qualifications

Job Requirements and Preferences:

Minimum Degree Required

Bachelor Degree

Minimum Years Of Experience

3 year(s) of Healthcare Compliance experience, such as consulting, risk management or operational roles.

Preferred Qualifications

Degree Preferred:

Master of Business 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 thorough knowledge of and/ or proven record of success in roles involving healthcare compliance, preferably for 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 leveraging compliance hotline protocols and compliance investigation process and procedures;
• Exhibiting familiarity with healthcare compliance regulatory agencies and a general understanding of healthcare laws and regulations (e.g., HIPAA, CMS, Medicare, Medicaid, Affordable Care Act, Anti-Kickback, Fraud and Abuse laws, False Claims Act, Accreditation, Research and Academic Medical Center experiences); and,
• Managing and evaluating professional staff.
  
  

Demonstrates Thorough Level Of Abilities And/or Proven Record Of Success In Managing Client Engagements Related To Directing And Implementing Ethics And Compliance Programs Within The Healthcare Industries, Preferably 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 internal audits emphasizing clinical, legal, auditing or other compliance areas;
• Identifying and addressing client needs, building solid 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.
  
  

Learn more about how we work: https://pwc.to/how-we-work

PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy.

All qualified applicants will receive consideration for employment at PwC without regard to race; creed; color; religion; national origin; sex; age; disability; sexual orientation; gender identity or expression; genetic predisposition or carrier status; veteran, marital, or citizenship status; or any other status protected by law. PwC is proud to be an affirmative action and equal opportunity employer.

For positions based in San Francisco, consideration of qualified candidates with arrest and conviction records will be in a manner consistent with the San Francisco Fair Chance Ordinance.

Applications will be accepted until the position is filled or the posting is removed, unless otherwise set forth on the following webpage. Please visit this link for information about anticipated application deadlines: https://pwc.to/us-application-deadlines

For positions in California, Colorado, Hawaii, Nevada, New York State, or Washington State, or for opportunities that will report to a supervisor, office or other work site in New York State, please visit the following link for pay range information: https://pwc.to/payrange-v1-advisoryseniorassociate