VULNERABILITIES

Aridell Associates, LLC

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

A vulnerability is defined as a condition of being susceptible to harm or injury, such as a system weakness prone to potential fraud, waste, or abuse.  Vulnerability identification generally originates through the analysis and oversight of data and information and the evaluation of internal controls, operations, processes, programs, and systems.  Identifying vulnerabilities is one way to proactively prevent fraud, waste, and abuse and mitigate risk.

Although it’s not the primary focus, all firms need to play a major role in identifying vulnerabilities.  Failing to place emphasize on it can lead to declining profitability, unwanted litigation, or an organization’s demise.  In recent years, vulnerabilities have plagued the most prominent industries, such as the banking, healthcare, mortgage, insurance, retail, securities and investments industries.

In the current climate, regulators primarily identify vulnerabilities on behalf of industries then pursue the catalysts of each one.  Regulatory actions can lead to costly audits, enforcement actions, criminal and civil litigations, fines and penalties, and adverse publicity.  Embracing a proactive approach towards vulnerabilities in lieu of a passive one can help an organization minimize disruptions, such as increased regulatory oversight, to its operations.

Aridell is an industry leader in vulnerability identification and mitigation.  Experts possess experience in identifying areas prone to exploitation and deploying risk mitigation strategies to curb financial and non-financial harm.  Our professional experience includes the two industries most affected by vulnerabilities—healthcare and insurance.

 
Aridell can aid organizations in the development of approaches to identify vulnerabilities, detection of vulnerabilities, mitigation of vulnerabilities, and assessment of the monetary and non-monetary effects of vulnerabilities.  In the healthcare insurance industry, experts have played a major role in identifying vulnerabilities in federal healthcare programs through data analysis and mining and specifically identified vulnerabilities in benefit design, claims processing, provider credentialing/recredentialing, licensing, eligibility and enrollment, prescription drugs, provider enrollment and networks, regulatory requirements, and healthcare settings.

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Aridell’s capabilities include:

  • Vulnerability Identification

  • Establishing and Implementing Protocols for Vulnerability Identification

  • Vulnerability Mitigation Strategies

  • Financial and Non-Financial Impact Attributed to Vulnerabilities

  • Regulatory Report Preparation

  • Self-Disclosure/Reporting Client Support