Investigator, Special Investigations Unit

This is a fully remote position, open to applicants in Oklahoma.

📋 Description

• Conducting thorough investigations into any claims of Medicaid healthcare fraud, waste, or abuse.

• Partnering with Compliance, State Medicaid Plans, Health Plans, and Coding teams.

• Creating an investigation strategy and collecting relevant information.

• Overseeing an active case load to ensure timely completion of tasks and adherence to compliance standards.

• Interviewing healthcare providers, patients/members, and other involved parties.

⛳️ Requirements

• Must be a resident of Oklahoma.

• Experience in conducting healthcare investigations.

• Minimum of 2 years' experience in healthcare fraud investigation.

• Proficiency in utilizing fraud, waste, and abuse (FWA) detection tools and enterprise databases for data mining, analysis, and information gathering.

• Willingness to travel and engage in legal proceedings, arbitrations, depositions, etc.

🏝️ Benefits

• Medical coverage

• Dental coverage

• Vision coverage

• Paid time off

• Retirement savings options

• Wellness programs