Director - Health Advisory Risk Compliance - PricewaterhouseCoopers - Washington

Job Description

Healthcare is a transforming industry due to legislative and regulatory demands, technology challenges, and societal trends. Our growing Health Industries Advisory practice provides management, technology and risk consulting services to help healthcare institutions around the world to anticipate and address their most complex business challenges. Our practitioners are supported by a dedicated health research unit, which is managed by a physician partner and provides our clients with cutting-edge intelligence, perspective, and analysis on issues transforming the health industry.
Our professionals have deep health industry expertise and include physicians, nurses, system specialists, health policy analysts, actuaries, financial advisors, and data analysts. The Healthcare Advisory practice is aligned across: Healthcare Provider, Healthcare Payers, and Pharmaceutical and Life Science.

Our Risk & Regulatory consultants help clients understand and address their enterprise risk and regulatory profile. This high performing team advises clients on the overall management and performance of their business, with a focus in compliance management, business continuity, risk and governance, and treasury management.

Healthcare is a transforming industry due to legislative and regulatory demands, technology challenges, and societal trends. Our growing Health Industries Advisory practice provides management, technology and risk consulting services to help healthcare institutions around the world to anticipate and address their most complex business challenges. Our practitioners are supported by a dedicated health research unit, which is managed by a physician partner and provides our clients with cutting-edge intelligence, perspective, and analysis on issues transforming the health industry. Our professionals have deep health industry expertise and include physicians, nurses, system specialists, health policy analysts, actuaries, financial advisors, and data analysts. The Healthcare Advisory practice is aligned across: Healthcare Provider, Healthcare Payers, and Pharmaceutical and Life Science.

Our Risk & Regulatory consultants help clients understand and address their enterprise risk and regulatory profile. This high performing team advises clients on the overall management and performance of their business, with a focus in compliance management, business continuity, and risk and governance. Position/Program RequirementsMinimum Years of Experience: 10

Minimum Degree Required: Bachelor's degree

Degree(s) Preferred: Advanced degree i.e. Juris Doctor, Masters of Business Administration, Masters of Public Health

Demonstrates Proven Expertise And Success Leading Compliance-related Consulting Engagements Within a Top Consulting Firm, Including

Development of client-focused solutions based on understanding strategy, operations and management in a number of functional areas of corporations and organizations.
Acquisition and management of engagements involving the integration of governance, risk and compliance, emphasizing corporate compliance (i.e. developing and assessing corporate compliance programs, constructing monitoring and auditing programs, supporting internal risk assessments and/or investigations, and implementing and/or operating integrated compliance controls in business practices) related to Medicare, Medicaid or Health Insurance Exchange regulations, requirements, and operating environments.
Audit preparations and responses to requests for federal and state regulators within the Healthcare Industry.
Participation in development of presentations or reports to management level audiences and supporting implementing enhanced and/or best practices at clients/companies.
Communications with clients in an organized and knowledgeable manner, delivering clear requests for information, demonstrating flexibility in prioritizing and completing tasks and communicating potential conflicts to a supervisor.
Demonstrated proven functional expertise and industry knowledge associated with one or more of the following functional domains: CMS Audit Protocols, Corporate and Medicare Compliance Programs, Medicare-Medicaid Program Readiness, CMS Data Validation, Compliance Monitoring and Reporting.
Demonstrated proven considerable knowledge of at least three of the following: Patient Protection and Affordable Care Act (PPACA); Financial One-Third Audits; CMS Audit Program Protocols; Seven Elements; Program Compliance Oversight Group (PCOG), Anti-Bribery, Anti-Corruption (ABAC); and, Data Validation, Audit Compliance Monitoring Programs, Medical Affairs & Clinical Compliance.

Demonstrates Proven Expert-level Abilities And Success Advising Clients On Compliance And Regulatory Issues, Including

Assessing compliance risks and controls;
Developing and implementing compliance supervisory and control solutions;
Assisting with responses or remediation associated with regulatory actions;
Leveraging project management skills, emphasizing leading and facilitating teams and developing client proposals;
Identifying and addressing client needs: developing and sustaining deep client relationships using networking, negotiation and persuasion skills to identify and sell potential new service opportunities; preparing and presenting complex written and verbal materials; and defining resource requirements, project workflow, budgets, billing and collection;
Advising clients or senior management on compliance issues, regulatory interpretation, assessing compliance risk and controls, implementation compliance monitoring and controls;
Driving and directing multiple, complex projects with medium-to-large staff teams;
Leading teams to generate a vision, establish direction and motivate members, create an atmosphere of trust, leverage diverse views, coach staff, and encourage improvement and innovation; and,
Creating a positive environment by monitoring workloads of the team while meeting client expectations and respecting the work-life quality of team members; providing candid, meaningful feedback in a timely manner; and keeping leadership informed of progress and issues.

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