Director, Fraud Waste Abuse Monitoring and Program Compliance - PECS

JJ Innovative Medicine is recruiting for a Director, Fraud Waste Abuse (FWA) Monitoring and Program Compliance located in Titusville, NJ.At Johnson Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, treated, and cured, where treatments are smarter and less invasive, and solutions are personal. Through our expertise in Innovative Medicine and MedTech, we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow, and profoundly impact health for humanity. Learn more athttps://www.jnj.com/The Patient Engagement and Customer Solutions (PECS) organization serves patients, during their treatment journey with JJ Innovative Medicine therapies, to help overcome challenges to fulfillment, on-boarding and adherence. You will be a member of the Supplier Management Operations Excellence (SMOx) leadership team, working closely with PECS Patient Experience teams and other Solutions groups to deliver impact across a suite of patient support programs that ultimately ensure more patients can start stay on therapy.Job Description

The Director, Fraud Waste Abuse (FWA) Monitoring and Program Compliance at Johnson Johnson will have a unique opportunity to lead and shape the fraud prevention and program compliance efforts within the JJ Innovative Medicine portfolio. This role is critical in ensuring the effectiveness, integrity, and compliance of our organization's patient support programs. We are looking for an especially skilled individual with extensive knowledge of healthcare regulations, along with proven experience in program monitoring, analysis, and compliance management. As the Director, you will have the chance to lead an elite team and develop comprehensive tools to deliver significant business impact.

Key Responsibilities:

Lead Fraud Waste Abuse Monitoring Team Initiatives:

Develop and implement a comprehensive strategy for monitoring, identifying, and investigating instances of fraud, waste, and abuse within our patient support programs, adhering to all applicable regulations and internal policies. Types of patient support include programs providing patients with access, affordability, travel, transportation, pharmacy services, education, and other support.Lead all aspects of the day-to-day operations of the Fraud Waste Abuse monitoring function, collaborating with relevant internal and external teams to ensure efficient and effective program compliance.Develop and apply internal controls, processes, systems, and data analytics tools to uncover and deter fraud, waste, and abuse. Maintain strict compliance with established guidelines and recommended approaches.Lead and mentor a team, providing guidance, support, and coaching to foster their professional growth and achieve program goals.

Shape Program Enhancements Drive Program Design Innovations:

Analyze program data and generate reports to measure performance, identify trends, and propose corrective actions, providing actionable insights to different individuals or groups involved.Collaborate with cross-functional teams, including Legal, Compliance, Solutions teams, Operations, and Internal Audit, to address compliance issues, develop mitigation strategies, and shape future program requirements.Stay informed about industry trends, regulatory updates, and effective approaches to preventing fraud, waste, and abuse. Adapt programs in a proactive manner to meet changing requirements and ensure compliance.Provide strategic insights and recommendations to senior leadership regarding program enhancements, risk mitigation strategies, and process improvements.Establish and develop connections with external partners, including government agencies, industry associations, and external auditors, to ensure compliance with regulatory standards and industry guidelines.

JJ Enterprise Cash Flow: Directly influence impact cash flow opportunities through fund recovery, loss avoidance, and cost savings analyses workstreams across programs.

Culture: Foster a culture of compliance and integrity within the organization, promoting awareness and understanding of fraud, waste, and abuse prevention principles and best practices.

Leadership: As a member of the SMOx Leadership Team, model ethical, Credo-based leadership decision-making. Serve as a trusted advisor to senior leadership, providing regular updates on program performance, risks, and opportunities for improvement.

Partnership: Collaborate with the Legal and Compliance teams to ensure adherence to regulatory requirements and industry standards in fraud prevention and program compliance. Lead and facilitate training and educational initiatives for internal team members on fraud prevention, program compliance, and risk mitigation strategies.

Director, Fraud Waste Abuse Monitoring and Program Compliance - PECS

JJ Innovative Medicine is recruiting for a Director, Fraud Waste Abuse (FWA) Monitoring and Program Compliance located in Titusville, NJ.At Johnson Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, treated, and cured, where treatments are smarter and less invasive, and solutions are personal. Through our expertise in Innovative Medicine and MedTech, we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow, and profoundly impact health for humanity. Learn more athttps://www.jnj.com/The Patient Engagement and Customer Solutions (PECS) organization serves patients, during their treatment journey with JJ Innovative Medicine therapies, to help overcome challenges to fulfillment, on-boarding and adherence. You will be a member of the Supplier Management Operations Excellence (SMOx) leadership team, working closely with PECS Patient Experience teams and other Solutions groups to deliver impact across a suite of patient support programs that ultimately ensure more patients can start stay on therapy.Job Description

The Director, Fraud Waste Abuse (FWA) Monitoring and Program Compliance at Johnson Johnson will have a unique opportunity to lead and shape the fraud prevention and program compliance efforts within the JJ Innovative Medicine portfolio. This role is critical in ensuring the effectiveness, integrity, and compliance of our organization's patient support programs. We are looking for an especially skilled individual with extensive knowledge of healthcare regulations, along with proven experience in program monitoring, analysis, and compliance management. As the Director, you will have the chance to lead an elite team and develop comprehensive tools to deliver significant business impact.

Key Responsibilities:

Lead Fraud Waste Abuse Monitoring Team Initiatives:

Develop and implement a comprehensive strategy for monitoring, identifying, and investigating instances of fraud, waste, and abuse within our patient support programs, adhering to all applicable regulations and internal policies. Types of patient support include programs providing patients with access, affordability, travel, transportation, pharmacy services, education, and other support.Lead all aspects of the day-to-day operations of the Fraud Waste Abuse monitoring function, collaborating with relevant internal and external teams to ensure efficient and effective program compliance.Develop and apply internal controls, processes, systems, and data analytics tools to uncover and deter fraud, waste, and abuse. Maintain strict compliance with established guidelines and recommended approaches.Lead and mentor a team, providing guidance, support, and coaching to foster their professional growth and achieve program goals.

Shape Program Enhancements Drive Program Design Innovations:

Analyze program data and generate reports to measure performance, identify trends, and propose corrective actions, providing actionable insights to different individuals or groups involved.Collaborate with cross-functional teams, including Legal, Compliance, Solutions teams, Operations, and Internal Audit, to address compliance issues, develop mitigation strategies, and shape future program requirements.Stay informed about industry trends, regulatory updates, and effective approaches to preventing fraud, waste, and abuse. Adapt programs in a proactive manner to meet changing requirements and ensure compliance.Provide strategic insights and recommendations to senior leadership regarding program enhancements, risk mitigation strategies, and process improvements.Establish and develop connections with external partners, including government agencies, industry associations, and external auditors, to ensure compliance with regulatory standards and industry guidelines.

JJ Enterprise Cash Flow: Directly influence impact cash flow opportunities through fund recovery, loss avoidance, and cost savings analyses workstreams across programs.

Culture: Foster a culture of compliance and integrity within the organization, promoting awareness and understanding of fraud, waste, and abuse prevention principles and best practices.

Leadership: As a member of the SMOx Leadership Team, model ethical, Credo-based leadership decision-making. Serve as a trusted advisor to senior leadership, providing regular updates on program performance, risks, and opportunities for improvement.

Partnership: Collaborate with the Legal and Compliance teams to ensure adherence to regulatory requirements and industry standards in fraud prevention and program compliance. Lead and facilitate training and educational initiatives for internal team members on fraud prevention, program compliance, and risk mitigation strategies.

Education: Bachelor's degree required. MBA, post-graduate qualification, or other advanced degree strongly preferred.

Experience and Skills:

A minimum of 10 (ten) years of healthcare business or financial services experience is required.A minimum of 5 (five) years of pharmaceutical experience (or related) is required.A minimum of 3 (three) years of experience leading teams and developing high potential talent is required.Fraud investigation, Healthcare Compliance (HCC), or Audit experience is preferred.Demonstrated project leadership, data analytics, and legal terms/contract management skills are preferred.Must be able to work with ambiguity while establishing structure and process standards.

Communication: Adept at effectively communicating complex information in both written and verbal forms. Skilled at connecting with various audiences and communicating to engage and influence individuals at all levels within the organization. Proven ability to establish and maintain strong relationships with a diverse range of colleagues.

Collaboration: Effectively work in a team environment that will require you to coordinate activities and build partnerships across multiple internal/external organizations.

Problem-solving skills: Applies personal knowledge and all available resources to effectively resolve customer issues and ensure their satisfaction. Demonstrates a growth mindset by embracing new challenges, making informed decisions, and persevering through obstacles.

Accountability: Eager to set ambitious goals and take ownership for results. Proactive with defining actions and following through and inspiring others to do the same.

Flexibility: Can dynamically adjust priorities due to changing circumstances. An agile learner who is comfortable operating in a complex environment.

Persistence: Demonstrates conviction, proactivity, and persistence when influencing others and overcoming resistance.

Travel: This position is based in Titusville, NJ and requires up to 10% domestic travel.

The anticipated base pay range for this position is $142,000 to $244,950.

The Company maintains highly competitive, performance-based compensation programs. Under current guidelines, this position is eligible for an annual performance bonus in accordance with the terms of the applicable plan. The annual performance bonus is a cash bonus intended to provide an incentive to achieve annual targeted results by rewarding for individual and the corporation’s performance over a calendar/performance year. Bonuses are awarded at the Company’s discretion on an individual basis.

Employees and/or eligible dependents may be eligible to participate in the following Company sponsored employee benefit programs: medical, dental, vision, life insurance, short- and long-term disability, business accident insurance, and group legal insurance.Employees may be eligible to participate in the Company’s consolidated retirement plan (pension) and savings plan (401(k)).This position is eligible to participate in the Company’s long-term incentive program.Employees are eligible for the following time off benefits:Vacation – up to 120 hours per calendar yearSick time - up to 40 hours per calendar year; for employees who reside in the State of Washington – up to 56 hours per calendar yearHoliday pay, including Floating Holidays – up to 13 days per calendar year of Work, Personal and Family Time - up to 40 hours per calendar yearAdditional information can be found through the link below. https://www.careers.jnj.com/employee-benefits

The compensation and benefits information set forth in this posting applies to candidates hired in the United States. Candidates hired outside the United States will be eligible for compensation and benefits in accordance with their local market."

Johnson Johnson is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

Education: Bachelor's degree required. MBA, post-graduate qualification, or other advanced degree strongly preferred.

Experience and Skills:

A minimum of 10 (ten) years of healthcare business or financial services experience is required.A minimum of 5 (five) years of pharmaceutical experience (or related) is required.A minimum of 3 (three) years of experience leading teams and developing high potential talent is required.Fraud investigation, Healthcare Compliance (HCC), or Audit experience is preferred.Demonstrated project leadership, data analytics, and legal terms/contract management skills are preferred.Must be able to work with ambiguity while establishing structure and process standards.

Communication: Adept at effectively communicating complex information in both written and verbal forms. Skilled at connecting with various audiences and communicating to engage and influence individuals at all levels within the organization. Proven ability to establish and maintain strong relationships with a diverse range of colleagues.

Collaboration: Effectively work in a team environment that will require you to coordinate activities and build partnerships across multiple internal/external organizations.

Problem-solving skills: Applies personal knowledge and all available resources to effectively resolve customer issues and ensure their satisfaction. Demonstrates a growth mindset by embracing new challenges, making informed decisions, and persevering through obstacles.

Accountability: Eager to set ambitious goals and take ownership for results. Proactive with defining actions and following through and inspiring others to do the same.

Flexibility: Can dynamically adjust priorities due to changing circumstances. An agile learner who is comfortable operating in a complex environment.

Persistence: Demonstrates conviction, proactivity, and persistence when influencing others and overcoming resistance.

Travel: This position is based in Titusville, NJ and requires up to 10% domestic travel.

The anticipated base pay range for this position is $142,000 to $244,950.

The Company maintains highly competitive, performance-based compensation programs. Under current guidelines, this position is eligible for an annual performance bonus in accordance with the terms of the applicable plan. The annual performance bonus is a cash bonus intended to provide an incentive to achieve annual targeted results by rewarding for individual and the corporation’s performance over a calendar/performance year. Bonuses are awarded at the Company’s discretion on an individual basis.

Employees and/or eligible dependents may be eligible to participate in the following Company sponsored employee benefit programs: medical, dental, vision, life insurance, short- and long-term disability, business accident insurance, and group legal insurance.Employees may be eligible to participate in the Company’s consolidated retirement plan (pension) and savings plan (401(k)).This position is eligible to participate in the Company’s long-term incentive program.Employees are eligible for the following time off benefits:Vacation – up to 120 hours per calendar yearSick time - up to 40 hours per calendar year; for employees who reside in the State of Washington – up to 56 hours per calendar yearHoliday pay, including Floating Holidays – up to 13 days per calendar year of Work, Personal and Family Time - up to 40 hours per calendar yearAdditional information can be found through the link below. https://www.careers.jnj.com/employee-benefits

The compensation and benefits information set forth in this posting applies to candidates hired in the United States. Candidates hired outside the United States will be eligible for compensation and benefits in accordance with their local market."

Johnson Johnson is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, or protected veteran status and will not be discriminated against on the basis of disability.