欺诈调查经理
Fraud Investigations Manager
职责
SafeGuard Services (SGS)，Peraton 的子公司，通过数据分析、调查和医疗审查来检测、预防、阻止、减少并转介欺诈、浪费和滥用行为。
我们正在寻找一位欺诈调查经理加入 SGS 专业人才团队。
你将负责：
此职位需要为调查员团队提供指导，以识别和研究潜在的欺诈、浪费和滥用问题。主要职责包括监督并协助案件的开发，以便转介给执法部门或其他机构，并回应现有案件工作的数据和支援请求。
- 为部门设定目标、目的和计划
- 激励员工并评估绩效
- 规划资源以满足工作量需求，设定优先级并报告部门活动
- 制定、管理并控制预算
- 管理薪酬和其他公司政策
- 招聘和发展员工
- 参与 CMS 和执法部门会议
- 领导调查团队和领导评估调查员
- 监督和管理工作量以满足合同要求
- 支持从马里兰州、华盛顿特区、宾夕法尼亚州、新泽西州、纽约州、马萨诸塞州、康涅狄格州、佛蒙特州、罗德岛州、缅因州、特拉华州、新罕布什尔州远程办公
资格要求
基本要求：
- 10 年相关经验，有监督或领导经验者优先
- 该职位需要具备出色的领导能力，并深入了解 Medicare 计划，能够审查索赔和供应商行为以发现潜在的欺诈、浪费和滥用迹象。
- 熟悉与 Medicare 服务费用支付相关的法规、法律、规则和规定。
- 优秀的组织和沟通能力，以及扎实的电脑操作技能。
- 能够独立工作，也能作为团队成员有效协作
- 需要美国公民身份
期望资格：
· 本科学位优先考虑
Peraton 概述
Peraton 是一家下一代国家安全公司，致力于在全球范围内以及延伸至银河系最远端的任务中取得成果。作为全球领先的任务能力集成商和转型企业 IT 供应商，我们为保护我们的国家和盟友提供值得信赖、高度差异化的解决方案和技术。Peraton 在传统与非传统威胁之间的关键交汇点上运作，覆盖所有领域。
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Responsibilities
SafeGuard 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
Qualifications
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
Peraton Overview
Peraton is a next-generation national security company that drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world’s leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies. Peraton operates at the critical nexus between traditional and nontraditional threats across all domains: land, sea, space, air, and cyberspace. The company serves as a valued partner to essential government agencies and supports every branch of the U.S. armed forces. Each day, our employees do the can’t be done by solving the most daunting challenges facing our customers. Visit peraton.com to learn how we’re keeping people around the world safe and secure.
Target Salary Range
$80,000 - $128,000. This represents the typical salary range for this position. Salary is determined by various factors, including but not limited to, the scope and responsibilities of the position, the individual’s experience, education, knowledge, skills, and competencies, as well as geographic location and business and contract considerations. Depending on the position, employees may be eligible for overtime, shift differential, and a discretionary bonus in addition to base pay.EEO
EEO: Equal opportunity employer, including disability and protected veterans, or other characteristics protected by law.Originally posted on Himalayas