Aridell Associates, LLC

PRINCIPALS

Julio Arias is a certified public accountant and possesses over 30 years of experience conducting and supporting criminal and civil investigations, including 20 years of healthcare fraud-related experience. He has conducted and supported criminal and civil investigations for the U.S. Department of Justice and worked jointly with Special Agents of the U.S. Department of Health and Human Services Office of Inspector General, the U.S. Federal Bureau of Investigation, the U.S. Department of Defense Office of Inspector General, U.S. Social Security Administration Office of Inspector General, Drug Enforcement Administration, U.S. Department of Veterans Affairs Office of Inspector General, U.S. Environmental Protection Agency Office of Inspector General, U.S. Federal Trade Commission, and State Attorney Generals' Offices.


Julio has served several Fortune ranked companies in prominent leadership roles, such as program director, project manager, and operations manager, under government contracts involving program integrity operations, where he provided technical expertise, oversaw data analytics, and developed audit protocols for evaluating the effectiveness of compliance programs. Over the past 10 years, he led the operations for several national and regional contracts under the Centers for Medicare & Medicaid Services.  Julio has further led and conducted contract, compliance, financial, and performance audits involving federal government programs and designed mechanisms to recover overpayments due to errors or fraud, waste, and abuse.

Susan J. Waddell has over 30 years of experience with Federal and State health care programs, private insurance and regulatory agencies. She has consulted with national health plans on fraud and abuse issues, compliance and training.  Most recently, she served as the Program Director on the Probable Fraud Measurement Pilot contract with the Centers for Medicare & Medicaid Services.  Given her expertise in health care fraud and abuse, Susan has consulted with State agencies to develop and deliver training for law enforcement and State regulators related to the Prescription Monitoring Program and Drug Diversion Investigations.

Ms. Waddell is a former Special Agent in Charge (New England Region) for the U.S. Department of Health and Human Services, Office of Inspector General where her region conducted criminal and civil investigations and led the nation in recoveries related to Health Care Fraud.  She spent a year in Washington, D.C. working on special projects related to administrative sanctions and exclusions; and collaborating with the Centers for Medicare and Medicaid on fraud solutions.    Additionally, Susan served as a special agent for the Arizona Medicaid Fraud Control Unit and worked closely with Medicaid program developers to address vulnerabilities and investigate fraud.


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Julio Arias, III

​Susan J. Waddell

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​​​

​Serving tHE Healthcare,

Financial, Insurance, and Public SectorS

THE TEAM