Fraud Investigations Manager — Remote Telework

Remote Jobs; United States; Remote; USD 80,000 - 128,000; Full time

Job summary

SafeGuard Services (SGS), a subsidiary of Peraton, seeks a senior investigator to lead a staff of investigators in identifying and researching Medicare fraud, waste and abuse. You will oversee case development for referral to law enforcement and provide data support for ongoing investigations.

The role requires proven leadership, deep Medicare program knowledge, and the ability to work independently or as part of a team. Telework is available from several US states.

Qualifications

• 10 years of experience, may have supervisory or lead experience.
• In-depth knowledge of the Medicare Program as it pertains to reviewing claims.
• Knowledge of Medicare requirements, laws, rules and regulations related to payment for services.
• Excellent organizational and communications skills and strong PC skills.
• Ability to effectively work independently and as a member of a team
• US citizenship required

Responsibilities

• Provide direction to investigators to identify issues of potential fraud, waste and abuse.
• Oversee development of cases for referral to law enforcement.
• Respond to data requests and support for existing casework.
• Set goals, objectives and plans for the unit.
• Motivate staff and evaluate performance.
• Plan resources, priorities and report unit activity.
• Develop, administer and control a budget.
• Recruit and develop staff.
• Lead a team of investigations and Lead Assessment Investigators.
• Oversee 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

Skills

Leadership

Medicare knowledge

Organizational skills

Communications skills

Teamwork

US citizenship

Education

Bachelor's degree

Job description

SafeGuard Services (SGS), a subsidiary of Peraton, seeks a senior investigator to lead a staff of investigators in identifying and researching Medicare fraud, waste and abuse. You will oversee case development for referral to law enforcement and provide data support for ongoing investigations.

The role requires proven leadership, deep Medicare program knowledge, and the ability to work independently or as part of a team. Telework is available from several US states.