CMS/Pharmacy Program Audit - Senior AssociateJob Category Regulatory Risk and Compliance Line of Service Consulting Services Level Senior Associate Specialty/Competency Conduct and Compliance Industry/Sector Pharma and Life Sciences Job Type Regular Time Type Full time Travel Requirements Up to 20% Job ID 427495WD Location(s) FL-Tampa, NC-Charlotte, IL-Chicago, DC-Washington, NY-New York, US-Remote, CA-San Francisco, WA-Seattle
A career within Regulatory Risk and Compliance services, will provide you with the opportunity to help companies rethink their approach to risk and create a sustainable risk advantage. We’re a part of a unique client proposition, assisting our clients develop proper internal controls by leveraging analytics and technology solutions to underpin efficient execution of governance, to optimise their risk and compliance policies and processes, and improve business performance.
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 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.
Job Requirements and Preferences:
Minimum Degree Required:
Minimum Years of Experience:
Master of Business Administration
Additional Educational Preferences:
Juris Doctorate or Master of Public Health may be considered.
Demonstrates proven thorough knowledge of, and success performing on, compliance-related consulting engagements, including:
- Assisting in the development of solutions related to strategy, operations and management in:
1) 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;
2) Audit preparations and responses to requests within the Healthcare Industry;
- Participating in the proposal development efforts, as well as helping to implement standard industry practices to clients;
- Communicating 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.
Demonstrates proven thorough functional 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.
Demonstrates 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 success and thorough abilities advising clients or senior management on the following areas: - Compliance issues, regulatory interpretation, compliance assessments of risks and controls, and the implementation of compliance monitoring and controls. Demonstrates proven thorough abilities and success identifying and addressing clients or managers needs, including the following: actively participating in client or management discussions and meetings; managing engagements or projects including preparing concise, accurate documents and balancing project economics management with the occurrence of unanticipated issues.
Demonstrates proven success as a team leader and thorough abilities to lead teams, which include the following areas: creating a positive environment by monitoring workloads of the team while meeting client or management 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.
At PwC, our work model includes three ways of working: virtual, in-person, and flex (a hybrid of in-person and virtual). Visit the following link to learn more: https://pwc.to/ways-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.
For positions in Albany (NY), California, Colorado, Nevada, New York City, Washington State, or Westchester County (NY), please visit the following link for pay range information: https://pwc.to/payrange-v1-advisoryseniorassociate
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