Complaint Intake

Full-service call center expertise, including intake, prioritization, business risk, triage, trending, and tracking system services.

Investigations

Leading edge proactive and reactive criminal, civil, and internal investigations to address fraud, waste, and abuse, regulatory requirements, and misconduct.  Experts in root cause analysis and driving solutions to resolve and mitigate weaknesses.

Data Analysis

Industry leader in conducting quantitative and qualitative data analysis of big data, such as healthcare and pharmacy claims, to detect and prevent fraud, waste, and abuse.

Vulnerabilities

Subject matter experience in identifying areas prone to exploitation, fraud, waste, and abuse and deploying risk mitigation strategies to curb financial and non-financial harm.

Aridell’s focus is to provide our clients subject matter expertise when an identified corporate compliance gap surfaces and to mitigate the associated potential, emerging, or identified risks, such as financial and non-financial adverse events.  Our ultimate goal is to help our clients protect their valuable assets as well as bestow customer confidence in their operations.

Founded in 2013, our team possesses extensive professional experience in auditing, analyzing, and investigating fraud, waste, and abuse in commercial and federal programs and has yielded high returns on investment along with favorable outcomes.  In the healthcare industry, Aridell’s principals are highly regarded as experts in the areas of compliance programs, federal healthcare programs, the pharmaceutical industry, and pharmacy operations as a result of their federal and state law enforcement experience and managing nationwide and regional program integrity contracts on behalf of federal government clients.

When it comes to leading effective program integrity operations, Aridell is second to none having yielded high returns on investment to the U.S. Department of Justice, Defense Contract Audit Agency, and the Office of Inspector General of the Environmental Protection Agency, U.S. Department of the Health and Human Services, and U.S. Department of Veterans Affairs.

​Serving tHE Healthcare,

Financial, Insurance, and Public SectorS

Auditing

Experts in conducting risk assessments and executing compliance, contract, financial, fraud, and performance audits.

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COMPANY OVERVIEW

Job Title: Sr. Project Manager/Lead (Full-Time)
Post Date: 5/26/2023 – 06/30/2023

Position Summary
Aridell Associates, LLC, a professional consulting firm, advises clients on healthcare program operations and helps clients develop solutions to maximize meaningful outcomes, improve their operations, and protect their valuable assets, as well as bestow customer confidence in their operations.  Our mission is to advance clients’ operational performance and provide sustainable long-term, successful business strategies.

If you are interested in providing consulting and advisory services or supporting contracts, then this project management level position is for you.  The Sr. Project Manager/Lead works as an integral member of a multi-disciplinary team in conducting program vulnerability activities in support of a contract. In this position, you will support the primary project manager in managing and leading program vulnerability projects, such as conducting research, identifying vulnerabilities, scoring risks, and reporting results. The Sr. Project Manager/Lead will receive all direction and instructions from a program manager or their designee for the work activities under the contract. 

Responsibilities

• Under minimal supervision, interact with the client's various partners and stakeholders to discuss and address program fraud, waste, and abuse schemes; trends, patterns, and anomalies; and opportunities for improvement.
  
• Contributes to improving operations and work flow efficiencies.
  
• Responds to partners' and stakeholders' needs for information and clarification.
  
• Uses positive interpersonal skills in conducting all work.
  
• Develops and delivers presentations.
  
• Prepares standard and ad hoc deliverables for clients.
• Lead teams responsible for identifying, triaging, and prioritizing existing and emerging vulnerabilities in healthcare programs.
  
• Provide guidance and support for vulnerability mitigation, and evaluate the success and impact of the mitigation strategies and completed actions in order to close vulnerabilities.
• Promote the use of environmental scanning techniques to identify vulnerabilities.
  
• Develop and prepare written risk assessments on different client programs and areas using standardized criteria.
  
• Oversee the preparation of reports, including the findings and associated recommendations for submission to the client’s management.
• Interact and confer with team members on a variety of topics, such as ideas, projects, approaches, methodologies, and strategies, using all forms of available communications.
• Interpret complex healthcare and value-based payment programs' policies, laws, rules, regulations, manuals, and healthcare industry guidelines in conducting program vulnerability activities.
  
• Serve as a technical resource in complex healthcare operations, data, and systems.

Qualifications

• ​The position requires a bachelor’s degree with preference given to those degrees in a business, public policy, or public administration relevant field. 
• At least five years of experience required in Marketplace, Medicare, Medicaid, and CHIP programs with an expert level of understanding of the regulations in the programs along with direct supervision of staff.
  
• Experience working for a health plan or an oversight/regulatory government agency is preferred.​
  

 
Skills

• Ability to work under pressure and short deadlines.
• Requires professional presentation skills.
• Strong organizational planning and prioritization skills with the ability to collaborate with others and multi-task.
• Excellent written and verbal communication skills.
• Ability to present to large or small groups when required.
• Proficient in using the Microsoft Office Professional Suite, including Word, Excel, PowerPoint, and Outlook.
  

Travel Requirements
No travel is required. 

Job Location
This is a work-from-home/remote position.

Apply Now
Email Resume To: jarias@aridell.com​​​

Aridell Associates, LLC

​Compliance

Well-versed in establishing and evaluating compliance programs in accordance with regulatory requirements and measuring the effectiveness of compliance programs.