Compliance Subject Matter Expert (SME) en INDEX ANALYTICS LLC

Compliance SME

Index Analytics LLC is a rapidly growing Baltimore-based small business providing health-related consulting services to the federal government. At the center of our company culture is a commitment to instilling a dynamic and employee-friendly place to work. We place a priority on promoting a supportive and collegial team environment and enhancing staff’s experience through career development and educational opportunities.

We are seeking a Compliance Subject Matter Expert to examine and assess providers’ compliance related to healthcare legislation. This position conducts research and analysis, pulls information, cites regulations using regulatory language, reviews provider documents, and provides complete written reports of enforcement Investigations of a provider to determine compliance. This opportunity is especially attractive to someone who likes to research legal and regulatory requirements and has an analytical mind. 

Responsibilities

• Conducts and oversees comprehensive investigations into potential violations to determine provider compliance with contractual obligations and regulatory requirements.
• Drafts and reviews detailed, substantive investigative reports, complaint summaries, and findings documents for internal and client use.
• Performs in-depth analysis of provider operations and documentation to identify trends, compliance gaps, and process inefficiencies.
• Leads the development, review, and maintenance of project artifacts—including User Guides, Standard Operating Procedures (SOPs), workflows, and templates—based on evolving project and client requirements.
• Mentors and supports junior investigators, providing guidance on best practices in investigative techniques, documentation, and client communication.
• Identifies and implements process improvements to enhance team efficiency, accuracy, and overall project performance.
• Facilitates and leads virtual meetings with providers and stakeholders to present findings, clarify documentation requests, and support compliance initiatives.
• Collaborates with cross-functional teams, project leadership, and external agencies to ensure consistent application of compliance standards and regulatory interpretations.
• Maintains clear, organized, and detailed records of investigative actions, findings, and follow-up efforts to ensure transparency and audit readiness.

Qualifications

• Minimum of four (4) years post-education work experience in a corporate Fraud, Waste, and Abuse (FWA) position; Master’s degree in a business or technical field to substitute for 2 years’ experience
• Bachelor’s degree in public policy, public health, health administration, business, or a related field, from an accredited college/university
• Minimum of two (2) years’ experience working on Healthcare Fraud and Compliance
• A Healthcare Fraud, Waste, and Abuse (FWA) Certification is preferred
• Management experience preferred (organization and personnel)
• Possess a working knowledge of compliance laws, regulations, and healthcare industry practices
• Possess a working knowledge of health insurance cost sharing requirements for Medicare, Medicaid, and private insurance and/or the ability to quickly learn complex information and apply the information to conducting investigations
• Detail-oriented and Strong writing skills
• Self-directed and deadline-driven
• Flexible and proactive team player

Attention Candidates

We're dedicated to ensuring a safe and transparent recruitment process for all candidates and have implemented robust measures to protect your personal information. Please be aware that all employment-related communications will originate from a secure portal ([email protected]) or a corporate email address ([email protected]). If you have any concerns, please don't hesitate to reach out to us at [email protected].

If you are selected for an interview, please be advised that Index Analytics LLC reserves the right to prohibit the use of artificial intelligence (AI) tools, including but not limited to AI-generated responses, real-time transcription, or automated assistance during the interview process. We value authentic interactions and the opportunity to engage directly with candidates. Any unauthorized use of AI may result in disqualification from consideration.

The salary range provided represents the estimated compensation for new hires in this position, applicable across all locations. Actual offers may vary based on factors such as the candidate's skills, qualifications, experience, and market conditions. Index complements its base salary offering with a competitive package that includes health and retirement benefits, discretionary bonuses, and reimbursement for professional development opportunities.

Index Analytics provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.