Program Integrity Contract Lead - Strategy & Compliance

NEPSE Trading

United States

Remote

USD 110,000 - 150,000

Full time

3 days ago
Be an early applicant
Application generator

Stand out for this role — generate a tailored resume and cover letter in about a minute.

Get past ATS filters

Job summary

NEPSE Trading is seeking a PI Contract Lead to join the leadership team. You will work with Program Integrity leadership, the Compliance Officer, and the Compliance Committee to ensure contract compliance with federal health care programs, FAR, and related regulations. You will analyze processes and drive measurable improvements.

You will identify risks, perform root cause analyses, prepare data reports, and support implementation of corrective actions. This role requires U.S.

Qualifications

  • 5+ years of Program Integrity and/or Payment Integrity experience.
  • 2+ years of project management experience (ideally in implementing large contracts).
  • U.S. citizenship required for this position (DoD contract).
  • Ability to obtain government security clearance (NBIS).
  • Experience reading and interpreting contracts, policies, and operations manuals.

Responsibilities

  • Translate contract requirements into business processes, workflows, controls, procedures, and operational requirements.
  • Identify operational gaps and recommend changes to meet contractual requirements; support SOPs and training materials.
  • Establish and maintain a contract monitoring framework with SLAs, KPIs, deliverables, and milestones.
  • Apply Lean, Six Sigma, root cause analysis and other process improvement methodologies.
  • Review contract requirements and ensure alignment of operational processes with obligations.

Skills

Program Integrity
Project management
Data analysis
Root cause analysis
Contract interpretation
Communication
Presentations
Microsoft Office

Education

RN/BSN
CPC
CCS
CCDS
CHC
HCAFA
AHFI
CFE
JD

Tools

Microsoft Excel
PowerPoint
Word

Job description

NEPSE Trading is seeking a PI Contract Lead to join the leadership team. You will work with Program Integrity leadership, the Compliance Officer, and the Compliance Committee to ensure contract compliance with federal health care programs, FAR, and related regulations. You will analyze processes and drive measurable improvements.

You will identify risks, perform root cause analyses, prepare data reports, and support implementation of corrective actions. This role requires U.S.

Get your free, confidential resume review.

or drag and drop your file here.

Similar jobs

Similar jobs worth comparing

Remote PI Contract Lead — Compliance & Strategy
Remote PI Contract Lead — Compliance & Strategy

Humana Inc • Phoenix (AZ)

Remote
USD 95,000 - 131,000
Remote Program Integrity Contract Lead
Remote Program Integrity Contract Lead

Humana Inc • Olympia (WA)

Remote
USD 95,000 - 131,000
Remote work
Travel flexibility
Remote Program Integrity Lead - Contracts & Compliance
Remote Program Integrity Lead - Contracts & Compliance

Humana Inc • Santa Fe (NM)

Remote
USD 95,000 - 131,000
Remote Program Integrity Contract Lead & Process Improvement
Remote Program Integrity Contract Lead & Process Improvement

Humana Inc • United States

Remote
USD 95,000 - 131,000
Remote Work
Bonus program
Contract Integrity Lead — Remote Health Compliance
Contract Integrity Lead — Remote Health Compliance

Humana Inc • Denver (CO)

Remote
USD 95,000 - 131,000
Contract Integrity Lead: Compliance & Process Improvement
Contract Integrity Lead: Compliance & Process Improvement

Humana Inc • Trenton (NJ)

Remote
USD 95,000 - 131,000
Remote work
Travel may be required
Bonus eligibility
Program Integrity Contract Lead
Program Integrity Contract Lead

NEPSE Trading • United States

Remote
USD 110,000 - 150,000
Remote Program Integrity Contract Lead
Remote Program Integrity Contract Lead

Humana Inc • Madison (WI)

Remote
USD 95,000 - 131,000
Medical insurance
Dental insurance
Vision insurance
+5
Program Integrity Lead — Investigations & Compliance
Program Integrity Lead — Investigations & Compliance

Qlarant • Los Angeles (CA)

On-site
USD 120,000 - 150,000
Program Integrity Lead - Fraud Prevention & Compliance
Program Integrity Lead - Fraud Prevention & Compliance

Qlarant • Dallas (TX)

On-site
USD 90,000 - 120,000