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Overview This is a remote role that may only be hired in the following locations: Phoenix, AZ or ... Enhance automation and controls within core banking systems and UP platforms. * Improve data ...
Overview This is a remote role that may only be hired in the following locations: Phoenix, AZ or ... Enhance automation and controls within core banking systems and UP platforms. * Improve data ...
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Define and evolve the end to end architecture for the Agentic AI Claims Automation platform, including agent orchestration, workflow engines, integration layers, data pipelines, and model serving ...
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Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 7 days ago
Aledade rating
8.5
Based on 5 frontline employees who took The Breakroom Quiz
46th of 428 rated business services
Job description
- Advanced Data Analysis: Perform complex data mining and trend analysis to proactively assess compliance risks and enhance monitoring mechanisms, guiding the organization toward preventive measures.
- Strategic Dashboard Development: Create comprehensive compliance dashboards and automated reporting systems to enhance compliance program maturity and effectiveness, and to provide real-time insights into compliance performance and business insights.
- Predictive Modeling Leadership: Develop and implement predictive models to assess risk and identify strategic areas for compliance intervention, while optimizing resource allocation.
- Technology and System Optimization Leadership: Drive technological initiatives and system optimizations to align compliance operations with cutting-edge data analytics processes; develop automation to identify abnormalities and outliers that may be an indicator of non-compliance
- Cross-Departmental Leadership: Work cross-functionally to support all compliance functions (e.g., investigations, monitoring, risk assessment) to address compliance-related issues and help support the implementation of effective controls; Spearhead collaborative efforts across Product, Tech, BI, and other departments to ensure seamless data integration and process improvement, advocating for technological enhancements and compliance innovations.
- Analytical Strategy and Executive Reporting: Provide executive-level compliance insight based on data analytics to facilitate compliance discussions at the Board of Directors and Compliance Committee level; Develop metrics to measure progress against compliance program maturity model goals; Collaborate with the Compliance leadership to assess current program maturity levels and identify opportunities for enhancement.
- Bachelor's degree or equivalent combination of education and experience.
- Minimum of 8 years of progressive experience in data analytics with a strong focus on healthcare compliance program management, monitoring, auditing, or a combination of these areas.
- Proficiency in Tableau, SQL, and visualization tools
- Strong knowledge of HIPAA, fraud, waste, and abuse laws (Stark Law, Anti-Kickback Statute, False Claims Act).
- Excellent analytical, problem-solving, and critical thinking skills.
- Exceptional written and verbal communication skills, with the ability to translate complex data findings into clear and actionable guidance.
- Strong interpersonal skills and the ability to collaborate effectively with diverse teams.
- Understanding of healthcare regulations, including those specific to Accountable Care Organizations (ACOs) and value-based care models (e.g., MSSP, Direct Contracting).
- Compliance certification (e.g., CHC, CCEP).
- Experience with compliance management software or platforms.
- Experience working in a rapidly growing organization or startup environment.
- Familiarity with compliance program maturity models (e.g., OIG Seven Elements, DOJ Guidelines).
- Proficiency in G-Suite or Microsoft Office Suite.
- Prolonged periods of sitting at a desk and working on a computer.
About Aledade
Sourced by ZipRecruiter
Aledade is a leader in population health that is using innovative, value based solutions to transform the way physicians interact with their patients. We are on a mission to change healthcare for the better and solve complex problems within the healthcare system. We follow the simple but radical idea that Aledade only succeeds when our partner practices succeed. From our cutting-edge technology platform to practice transformation services, we provide physicians with everything they need to create and run an accountable care organization (ACO), revamping the way they practice and getting them back to where they should be: quarterbacking their patients' health care! Our customized solutions help clinicians in communities across America preserve their autonomy, deliver better care to their patients, reduce overall costs, and keep independent physician practices flourishing.
Industry
Health care and social assistance
Company size
501 - 1,000 Employees
Headquarters location
Bethesda, MD, US
Year founded
2014