Senior Specialist - Compliance

ConfidentialGurgaon / Gurugram, India

6 days ago

Job description

Job Description - Senior Specialist - India Integrity & Ethics Investigation

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation and workflow orchestration.

With over 30,000 employees globally and a robust presence in India, comprising over 17,000 employees across Delhi NCR, Hyderabad, Bangalore, and Chennai, we foster an inclusive culture where every team member feels valued and empowered. Our mission is to transform the healthcare industry by driving efficiency for healthcare systems, hospitals, and physician practices, continuously striving to make healthcare work better for everyone.

The Senior Specialist - Integrity & Ethics Investigations will be responsible for overseeing and performing confidential and sensitive compliance investigations, forensic data review, managing the intake and triage of complaints, concerns, and inquiries, documenting case information, and developing / writing reports / metrics. This person will also assist in the development of compliance / integrity training content and materials and interact with the global integrity & ethics team. This person will report to the Associate Director, Integrity & Ethics Investigations, and will assist in the development and optimization of R1's compliance investigation team.

In this role, the successful candidate will thoroughly investigate operational incidents, allegations related to violations in policy, and develop robust and timely case reports and metrics, as needed.

Responsibilities :

Manage compliance investigations including data review, conducting interviews of potential witnesses and subjects of the case, and drafting investigation reports
Assist with determining root cause analysis and recommending corrective action plans that address concerns or errors potentially discovered in the investigation
Oversee operational matters and perform other operational reviews, ensuring they are executed in a sensitive and confidential manner and with the highest levels of integrity, efficiency, and respectability, using investigating tools and methodologies
Manage R1's hotline system to ensure that all incoming complaints and concerns are timely and carefully handled, and appropriate follow-up action is taken
Assist with reviewing the compliance mailbox intake system and respond to inquiries as appropriate
Manage the security and storage of information, evidence, and documents related to investigations
Assist with preparing reports on investigation related metrics on an ad-hoc basis for presentation to senior management
Assist Compliance, and HR as necessary, to ensure the effective and efficient functioning of the investigation process and any other related duties as assigned from time to time
Stay informed of relevant compliance investigation best practices
Assist the global Integrity & Ethics team in the development and distribution of compliance-related training materials and 'integrity insights'

Required Qualifications :

Master's Degree or PGDM or CA, LLB / LLM

Minimum of 3 years of investigation experience in auditing firms or with an MNC.

Ability to read, comprehend and interpret detailed, complex written material and review data

Ability to simultaneously consider numerous facts, perceive patterns and relationships, develop theories about past occurrences based on numerous pieces of information or evidence, compare and interpret information, recognize and examine discrepancies, and draw logical conclusions

Ability to interview investigation subjects and witnesses and extract relevant information that is critical to an investigation

Ability to manage time to prioritize and combine investigations when practicable to ensure timely completion

Flexibility to work across multiple time zones when required

Excellent writing, communication, and analytical skills

Ability to handle several cases at one time

Ability to demonstrate cultural sensitivity through tact and courtesy when dealing with individuals from various social, cultural, racial, and economical backgrounds

Ability to work cooperatively as part of a team

Ability to prepare clear, concise written reports

Desired Qualifications :

Master's Degree, LLB / LLM

Relevant professional certifications such as CFE, CAMS, CCEP etc.

Revenue cycle management experience can be an added advantage.

Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests.

Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package. To learn more, visit :

Skills Required

Compliance, Root Cause Analysis, Data Review, Investigation, Analytical Skills

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Compliance Specialist • Gurgaon / Gurugram, India