Manager, Fraud and Waste • Special Investigations Unit - Medicaid

Candidates must possess a Bachelor's degree, a minimum of 3 years of experience in health insurance claims or Medicare, and at least 3 years of experience with Fraud, Waste, and Abuse in a Managed Care or government setting. Proven leadership skills with at least 3 years of direct management experience over seasoned professionals are required, along with excellent PC skills in MS Excel, Access, and PowerPoint. Strong communication, organizational, project management, and analytical skills are essential, including the ability to analyze large amounts of data. Candidates must be comfortable working core business hours aligned with Eastern Standard Time (EST) and have the ability to travel up to 15%. Preferred qualifications include knowledge of Medicare and Medicaid regulations, relevant certifications (BA, MBA, J.D., MSN, Clinical Certifications, CPC, CCS, CFE, AHFI), understanding of the healthcare industry, claims processing, internal investigative process development, and corporate/business operations.