Richard Merino is a Senior Managing Director at Ankura based in Washington, DC. He has 20 years of experience in operations, regulatory compliance, and process improvement within the healthcare industry focusing on Medicare and Medicaid plan sponsors, commercial managed care entities, hospital and provider practice organizations, pharmacy benefit managers, and other healthcare related entities. His expertise includes the development, evaluation, implementation, and evaluation of compliance programs, operational improvement initiatives, and risk management techniques.
Richard has managed and directed experienced teams in the preparation for and participation in numerous regulatory audits performed by governmental agencies including Centers for Medicare & Medicaid Services (CMS), state Medicaid departments, and the Office of Inspector General (OIG). He has performed operational risk detection, management, and remediation activities on behalf of managed care and governmental health plans and has successfully developed and executed numerous corrective action plans.
He has developed and managed full corporate, Medicare and Medicaid compliance programs, performed compliance effectiveness assessments, and implemented corporate compliance programs for numerous hospitals and managed care plans. He has also been named the interim corporate compliance officer for a large regional health plan and has worked with several health plans to implement full audit and monitoring programs.
Richard previously served as a managing director in PwC’s risk assurance segment and was responsible for the national healthcare compliance practice.
Richard’s professional experience includes: