Fraud Investigations Manager

This is a fully remote position, open to applicants in Connecticut, +9 more states.

📋 Description

• Provide leadership to a team of investigators focused on identifying and researching potential instances of fraud, waste, and abuse.

• Supervise and assist in the development of cases to be referred to law enforcement or other relevant entities.

• Address requests for data and provide support for ongoing casework.

• Establish the unit's goals, objectives, and strategic plans.

• Inspire staff and assess performance effectively.

• Plan resource allocation, manage workload demands, prioritize tasks, and report on unit activities.

• Develop, manage, and oversee the fiscal budget.

• Implement compensation and other corporate policies.

• Recruit and nurture talent within the team.

• Engage in meetings with CMS and law enforcement agencies.

• Lead a team of investigators and Assessment Investigators.

• Oversee and balance workload to ensure compliance with contractual obligations.

⛳️ Requirements

• A minimum of 10 years of experience, which may encompass supervisory or leadership roles.

• Demonstrated leadership capabilities.

• Extensive knowledge of the Medicare Program, particularly in relation to the review of claims and provider conduct for signs of potential fraud, waste, and abuse.

• Familiarity with Medicare requirements, laws, rules, and regulations governing service billing to the Program.

• Exceptional organizational and communication skills.

• Proficient in computer skills.

• Ability to work efficiently both independently and collaboratively within a team.

• U.S. citizenship is mandatory.

• No security clearance is necessary.

• A Bachelor's degree is advantageous.

🏝️ Benefits

• Telework options available from designated U.S. states and the District of Columbia.

• Employees may qualify for overtime pay.

• Employees may be eligible for a shift differential.

• Employees might qualify for a discretionary bonus.