Senior Compliance Investigator Federal Healthcare Programs

Reli Group Inc; Baltimore (MD); On-site; USD 90,000 - 110,000; Full time

Job summary

RELI Group, a Baltimore-based consultancy partnering with government agencies, seeks a Compliance Specialist III to strengthen program integrity across Medicare Part D and federal healthcare regulations. You will investigate, oversee compliance processes, and guide data-driven investigations.

Collaborate with CMS, OIG, and legal teams while mentoring junior staff. A background in drug pricing and government pricing, plus strong communication and project management, is preferred.

Qualifications

• Bachelor’s degree plus 5 years of relevant professional experience, or Associates degree plus 8 years of relevant professional experience, or High school diploma plus 9 years of relevant professional experience.

Responsibilities

• Review dispensers, pharmacies, and manufacturers’ practices to ensure adherence to Negotiation Program requirements.
• Develop compliance requirements to inform investigations, reporting, and market surveillance activities.
• Draft detailed investigation plans, memoranda, and final reports with actionable findings and recommendations.
• Coordinate with CMS, OIG, and other federal bodies on escalated matters requiring enforcement or corrective action.
• Mentor junior staff and serve as SME related to investigative techniques and healthcare program integrity.

Skills

Medicare Part D

Drug pricing

Healthcare regulations

Analytical skills

Investigative skills

Project management

Written communication

Education

Bachelor’s degree

Associates degree

High school diploma

Tools

Case management systems

e-discovery tools

Data analytics platforms

Job description

RELI Group, a Baltimore-based consultancy partnering with government agencies, seeks a Compliance Specialist III to strengthen program integrity across Medicare Part D and federal healthcare regulations. You will investigate, oversee compliance processes, and guide data-driven investigations.

Collaborate with CMS, OIG, and legal teams while mentoring junior staff. A background in drug pricing and government pricing, plus strong communication and project management, is preferred.