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Mgr Special Investigative Unit (Remote)
Company | Molina Healthcare |
Address | United States |
Employment type | FULL_TIME |
Salary | |
Category | Hospitals and Health Care |
Expires | 2023-07-31 |
Posted at | 10 months ago |
- Works with leadership to maintain and revise policies and procedures, fraud, waste, and abuse plans, annual audit work plans, including department guidance memos, and educational materials.
- Identifies opportunities for improvement through the audit process and provide recommendations for system enhancement to augment investigative outcomes and performance.
- Provides oversight and review of the SIU referral intake and investigation process while giving guidance and direction to team on case investigation steps and actions.
- Accurately tracks, reports, and follows up on overpayments and recoveries
- Leads business requirement process and reporting to ensure proper and timely notification of case activity to the appropriate regulatory and/or law enforcement agency.
- 5-7 years
- Active and unrestricted Accredited Health Care Fraud Investigator (AHFI) designation or Certified Fraud Examiner (CFE)
- Required License, Certification, Association
- Health Care Anti-Fraud Associate (HCAFA) designation
- 7-9 years
- Preferred License, Certification, Association
-
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