Director of Special Investigations
Behavioral Health Market Context
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Job Description
to final report stage
Required Qualifications
Bachelor's degree in Accounting, Criminal Justice, Finance, Medical Professional, Economics, Operations Management or related field or equivalent
7+ years of related compliance and / or special investigation experience in managed care or CMS
Required Qualifications
Bachelor's degree in Accounting, Criminal Justice, Finance, Medical Professional, Economics, Operations Management or related field or equivalent
7+ years of related compliance and / or special investigation experience in managed care or CMS
Qualifications
- •Bachelor's degree in Accounting, Criminal Justice, Finance, Medical Professional, Economics, Operations Management or related field or equivalent
- •7+ years of related compliance and / or special investigation experience in managed care or CMS
Benefits
Responsibilities
- •Oversee the activities of the SIU for accurate and timely operational reviews and final reviews
- •Interpret audit results and assist health plan executives in the development of appropriate action plans to address identified risks
- •Develop and implement continuous auditing processes from analytic design to final report stage
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