Fraud Investigations Manager Job New York New York USA,Management

Basic Qualifications:

10 years of experience, may have supervisory or lead experience
This position requires proven leadership skills and in-depth knowledge of the Medicare Program as it pertains to reviewing claims and provider behavior for indications of potential fraud, waste and abuse.
Knowledge of Medicare requirements, laws, rules and regulations related to payment for services billed the Program.
Excellent organizational and communications skills as well as strong PC skills.
Ability to effectively work independently and as a member of a team
US. citizenship required

Desired

Qualifications:

Bachelors degree is a plus

Safe Guard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.

We are looking to add a Fraud Investigations Manager to our SGS team of talented professionals

What you'll do:

This position entails providing direction to a staff of investigators to identify and research issues of potential fraud, waste and abuse. Primary responsibilities include oversight and assistance to the development of cases for referral to law enforcement or other entities and responding to requests for data and support for existing casework.

Establish goals, objectives and plans for the unit
Motivate staff and evaluate performance
Plan resources to address workload needs, set priorities and report unit activity
Develop, administer, and control a budget
Administer compensation and other corporate polices
Recruit and develop staff
Participation in CMS and Law Enforcement Meetings Lead a team of investigations and Lead Assessment Investigators
Oversee and manage workload to meet contractual requirements
Telework available from Maryland, District of Columbia, Pennsylvania, New Jersey, New York Massachusetts, Connecticut, Vermont, Rhode Island, Maine, Delaware, New Hampshire