Manager I Investigations directing Fraud Investigations Unit at Elevance Health, overseeing Medicaid fraud investigations and analysis of provider patterns. Leading a team and communicating with state agencies on fraud trends.
Responsibilities
Directs activities of the Fraud Investigations Unit overseeing Medicaid markets
Supervises investigations of alleged Medicaid fraud
Coordinates analysis of provider utilization patterns and trends
Oversees integration of various computer systems in the Unit
Communicates with Medicaid state agencies, CMS, OIG, and DOJ
Hires, trains, coaches, counsels, and evaluates performance of direct reports
Requirements
Requires a BA/BS in business or nursing
Minimum of 5 years in investigations
U.S. Citizenship required
Previous management experience preferred
CFE, AHFI, CPC Certifications preferred
Experience with Virginia and Arkansas Medicaid preferred
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