Note: The job is a remote job and is open to candidates in USA. First Principles & Concepts is seeking a Contract Compliance Review Analyst - Healthcare to conduct structured reviews of federal healthcare contract requirements. The role involves assessing compliance, identifying performance risks, and providing actionable recommendations to improve operational performance.
Responsibilities
- Conduct structured compliance reviews of federal healthcare contract requirements, modifications, manuals, deliverables, workflows, desk procedures, system outputs, and operational documentation
- Analyze how contract requirements are interpreted and executed across business processes, systems, reporting structures, and functional teams
- Develop contractual crosswalks that align requirements, source documentation, operational execution, evidence reviewed, identified gaps, and recommended actions
- Evaluate federal healthcare program operations to identify compliance risk, performance risk, interpretation inconsistencies, documentation gaps, and areas where execution may not align with contractual intent
- Review contract modifications, policy updates, procedural changes, and related documentation to assess operational impact and implementation requirements
- Assess medical management, case management, utilization management, referral management, population health, quality, reporting, and related other healthcare program functions from a contract compliance and operational execution perspective
- Conduct system and reporting reviews to determine whether outputs, metrics, data elements, and deliverables accurately support contractual and operational requirements
- Support audit readiness, internal review activities, corrective action planning, and leadership decision-making by preparing clear findings, risk assessments, summaries, and recommendations
- Review desk procedures, workflows, standard operating procedures, training materials, reports, and other supporting documentation to determine whether they adequately reflect applicable requirements
- Identify areas where inconsistent interpretation, insufficient documentation, system dependencies, or process variation may create compliance, performance, financial, or operational risk
- Prepare concise executive summaries, detailed findings, contractual crosswalks, risk assessments, and recommendation documents for senior leadership and program stakeholders
- Facilitate or support meetings with operational teams, subject matter experts, program leadership, and other stakeholders to gather information, validate findings, and clarify requirements
- Track review progress, open items, documentation requests, findings, and action items to ensure timely completion of assessment activities
- Exercise sound judgment when reviewing sensitive, complex, or time-critical issues and communicate findings clearly, professionally, and defensibly
- Work independently in a fast-paced environment with limited ramp-up time, while maintaining accuracy, organization, and attention to detail
Skills
- Minimum of 8 years of overall professional experience in federal healthcare, healthcare operations, contract compliance, program analysis, healthcare administration, managed care, government contracting, audit, quality, or a related field
- Minimum of 2 years of recent, directly relevant experience performing contract compliance reviews, contract oversight, requirements analysis, audit support, system review, operational compliance assessment, or similar work in a federal healthcare environment
- Federal Government or federal contractor experience required
- Experience reviewing and interpreting federal healthcare contract requirements, contract modifications, manuals, policies, deliverables, performance standards, operational procedures, or related source documentation required
- Bachelor's degree in Business Administration, Healthcare Administration, Public Health, Health Policy, Public Administration, or a related field required
- Strong understanding of federal healthcare program operations, federal contract environments, and the importance of contract-driven execution
- Ability to locate, read, interpret, and apply complex requirements from contracts, modifications, manuals, policies, deliverables, technical guidance, and related source documents
- Strong analytical skills with the ability to evaluate whether operational practices, workflows, documentation, systems, and reports align with contractual and regulatory requirements
- Knowledge of contract oversight, compliance review, audit support, corrective action planning, performance assessment, and operational risk identification
- Ability to assess complex healthcare operations and identify gaps, inconsistencies, risks, and practical opportunities for improved compliance and alignment
- Strong written communication skills, including the ability to produce clear executive summaries, detailed findings, crosswalks, recommendations, and briefing materials
- Strong verbal communication and facilitation skills, including the ability to work effectively with senior leaders, operational teams, subject matter experts, and cross-functional stakeholders
- Ability to translate complex technical, operational, contractual, or policy information into clear, actionable guidance
- Strong attention to detail and ability to maintain accuracy when reviewing complex requirements and documentation
- Ability to work independently, manage competing priorities, and deliver high-quality work under tight timelines
- Strong organizational skills, including the ability to track documentation requests, findings, risks, dependencies, and follow-up actions
- Ability to exercise discretion, sound judgment, and professionalism when handling sensitive contract, performance, compliance, or operational information
- Proficiency with Microsoft Office applications, including Word, Excel, PowerPoint, Outlook, Teams, and SharePoint
- Experience supporting healthcare operations in one or more areas such as medical management, case management, utilization management, referral management, population health, quality management, care coordination, claims, reimbursement, reporting, or program performance
- Experience developing findings, risk assessments, executive summaries, crosswalks, audit support documentation, corrective action recommendations, or leadership briefings
- Master's degree in Business Administration, Healthcare Administration, Public Health, Public Administration, Health Policy, or a related field
- Experience with Power BI, Visio, workflow tools, reporting systems, or contract/performance tracking tools
Benefits
- Health, Dental and Vision Insurance
- Group Life, Short Term Disability and Long-Term Disability Insurance
- 401K with company match
- Paid Time Off and Holidays
- Supplemental Benefits
Company Overview