Job Description

Healthcare Compliance Consultant

About Strategic Management Services

Strategic Management has 30+ years experience in the development, evaluation, and management of healthcare compliance and privacy programs. The Firm focuses exclusively on the healthcare industry and has assisted thousands of organizations with compliance and privacy regulatory and operational matters. We differentiate ourselves from competitors by the depth of experience, as well as the unique expertise, qualifications and people. Many Strategic Management consultants and professionals previously held positions in top U.S. health systems and in the Federal government, including its CEO, Richard Kusserow who was Inspector General for the Department of Health and Human Services.

About this Career Opportunity

Strategic Management is currently seeking a highly motivated professional for a Consultant position to work in our Alexandria, VA office. The Consultant will work on client engagements, working both in teams and independently to meet client needs and meeting regulatory requirements. The Consultant will be well versed in areas of healthcare compliance, specializing in operations of a compliance program, regulatory compliance and compliance risk areas.

Responsibilities Include

• Leads and provides interim or designated Compliance Officer services, offering expert staffing support to manage healthcare compliance program operations and regulatory compliance. Oversees the development and implementation of compliance policies, ensures compliance with regulatory requirements, conducts compliance risk assessments, and manages the compliance hotline. Provides strategic guidance to leadership, leads training initiatives, and ensures the effective application of compliance operations across the organization.
• Provides on-going advisory services to clients to assist them in effectively managing their regulatory and operational compliance risks, ensuring ongoing compliance with evolving regulatory requirements, and enhancing the overall integrity and security of their compliance programs.
• Conducts research and analysis on federal and state healthcare regulations including, but not limited to, Anti-Kickback Statute, False Claims Act, Stark Law, HIPAA and CMS regulations and presents the findings in a client-ready oral or written format. Present findings directly to clients.
• Lead investigations on behalf of clients into compliance incidents, analyze their impact, identify root causes, implement corrective actions, and fulfill reporting obligations to relevant authorities.
• Collaborates both independently and as part of a team to assess the effectiveness of clients' compliance programs, utilizing in-depth knowledge of healthcare laws, regulations, government guidance and industry standards. Leverages expertise to conduct thorough evaluations, identify areas for improvement, and provide actionable recommendations that align with applicable government requirements and industry best practices.
• Works closely with clients to understand their unique needs and advising clients on proposed enhancements to support compliance, strengthen organizational protections, and optimize the overall efficiency of their compliance frameworks.
• Collaborates both independently and as part of a team to design, develop, and implement comprehensive compliance programs tailored to meet the specific needs of clients' organizations. Ensures that these programs fully align with the standards set forth by HHS OIG and other relevant governing bodies, such as state-specific regulations and industry standards.
• Review and refine existing Strategic Management protocols to ensure they align with industry best practices and organizational standards, and contribute to the development of reports that effectively communicate findings, recommendations, and outcomes to stakeholders at all levels.
• Stays up-to-date on healthcare regulations and best practices to ensure compliance while providing guidance on compliance matters.
• Maintains professional certifications required for the position.
• Completes all assignments consistently on-time and at a professional level that meets quality and accuracy standards.

Qualifications

• Experience working with healthcare regulations, Anti-Kickback Statute, False Claims Act, Stark Law, HIPAA and other relevant federal laws and state laws.
• Experience with implementing and auditing healthcare compliance programs, conducting risk assessments, and managing compliance incidents and self-disclosures.
• Possess superior writing skills, excellent oral communication and presentation abilities, and exceptional interpersonal skills to effectively convey complex information and collaborate with diverse stakeholders.
• Role requires up to 75% travel to meet client needs, including on-site visits and meetings across various locations.

Education and Certification Requirements

• Master's Degree or Juris Doctor; preferably in the areas of Health Law and Policy, Health Administration, Public Health, Public Policy, or Public Administration.
• Holds an active healthcare compliance certification, such as CHC.
• Relevant experience spanning 5 to 7 years as a healthcare compliance consultant, HHS, OIG, CMS or other government role, and/or an in-house Compliance Officer at a healthcare provider.

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