Help Desk Specialist Tier II providing IT support for federal government contracts in fast - paced environment. Managing technical support for desktop, networking, and conferencing technologies.
DN
Onsite Special Investigations Unit Administrator
Posted last week
About the role
- Administrator providing regulatory and operational support for DWIHN's Special Investigations Unit. Ensuring compliance with Medicaid requirements and maintaining investigation integrity.
Responsibilities
- Provide administrative, operational, and regulatory support to DWIHN’s SIU.
- Maintain SIU case files from intake through closure, ensuring documentation is complete, accurate, and compliant with DWIHN policies and procedures.
- Track investigation milestones, statutory and contractual timelines, and case dispositions using DWIHN systems.
- Monitor intake sources including internal referrals, anonymous reports, provider self-disclosures, recipient complaints, and external agency referrals.
- Ensure proper version control, labeling, and storage of investigation materials in accordance with DWIHN records-retention requirements.
- Support SIU compliance with applicable regulations.
- Assist with preparation and tracking of referrals, notifications, and disclosures to relevant agencies as directed by Compliance leadership.
- Ensure all SIU activities align with DWIHN’s PIHP contract, Compliance Plan, and Program Integrity policies.
- Prepare investigation files for internal audits and site visits.
- Maintain SIU logs and dashboards tracking key metrics.
- Compile data for monthly, quarterly, and annual reports.
- Assist in identifying trends, repeat issues, and emerging risks.
- Schedule and coordinate interviews and case review meetings.
- Draft and format correspondence and case summaries.
Requirements
- Bachelor’s degree in Criminal Justice, Public Administration, Healthcare Administration, Business Administration, or a related field (or equivalent combination of education and experience).
- Minimum of 3–5 years of experience in healthcare administration, compliance, investigations, Medicaid programs, or government-regulated environments.
- Prior experience supporting a Special Investigations Unit, Program Integrity, Compliance, or OIG-facing function.
- Familiarity with: Claims review and recoupment processes
- Workforce Background Check requirements
- Provider enrollment and exclusion screening.
- Strong organizational, documentation, and record management skills.
- Demonstrated ability to manage multiple cases, deadlines, and competing priorities.
- High attention to detail and ability to maintain audit-ready files.
- Proficiency in Microsoft Office (Excel, Word, Outlook, PowerPoint) and electronic case-management or compliance systems.
- Strong written and verbal communication skills.
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