Senior Investigator – Medicare Part D & Compliance

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

Job summary

RELI Group, Inc. in Baltimore seeks a Senior Investigator to support federal healthcare program integrity through rigorous investigations, compliance oversight, and risk assessment.

You will analyze data, review pharmacies and manufacturers, and develop strategies with CMS, OIG, and stakeholders. The role requires expertise in Medicare Part D, drug pricing structures, and government pricing programs, paired with strong analytical, investigative, and communication skills.

Qualifications

• Bachelor’s degree or higher with relevant experience in Medicare Part D or government pricing.
• Strong analytical and investigative skills.
• Knowledge of federal healthcare regulations related to pharmaceutical pricing and compliance.

Responsibilities

• Support investigation lead with review of dispensers, pharmacies, and manufacturers’ practices.
• Develop compliance requirements for investigations, reporting, and market surveillance.
• Develop investigation processes to ensure timely, thorough investigations.
• Draft investigation plans, memoranda, and final reports with actionable findings.
• Coordinate with CMS, OIG, and other bodies on escalated matters.
• Maintain secure chain of evidence per federal guidelines.

Skills

Medicare Part D

Drug pricing

Government pricing programs

Analytical skills

Investigative skills

Regulatory knowledge

Communication

Writing

Project management

Case management systems

E-discovery tools

Data analytics platforms

Education

Bachelor’s degree

Associates degree

High school diploma

Tools

Case management systems

E-discovery tools

Data analytics platforms

Job description

RELI Group, Inc. in Baltimore seeks a Senior Investigator to support federal healthcare program integrity through rigorous investigations, compliance oversight, and risk assessment.

You will analyze data, review pharmacies and manufacturers, and develop strategies with CMS, OIG, and stakeholders. The role requires expertise in Medicare Part D, drug pricing structures, and government pricing programs, paired with strong analytical, investigative, and communication skills.