Medicare Investigations Lead - Complaints & Referrals (Remote)

Peraton; Reston (VA); A distancia; USD 66.000 - 106.000; Jornada completa

Descripción de la vacante

Peraton, a leading national security and IT solutions provider, seeks a Complaints/Referrals Team Lead for Medicare within SafeGuard Services (SGS). The role focuses on quality objectives, workload oversight, and case development for referrals to law enforcement or other entities.

You will mentor investigators and guide workflow development while maintaining independence within established policies. Responsibilities include managing monthly workload reviews, QC, and prioritizing referrals and

Formación

• 8 years with a BS/BA or 12 years with a HS Diploma
• At least 5 years of investigative experience
• Strong communication and organization skills
• Strong leadership background
• U.S. citizenship required

Responsabilidades

• Lead investigations and development of cases for referral to law enforcement or other entities
• Provide mentoring and guidance to investigative team
• Act as point of contact for manager and assist team with referrals background and workflow development
• Review workload and conduct QC for staff
• Monitor quality metrics and timeliness of case updates
• Mentor team members to detect fraud, waste, or abuse
• Enable telework from specified states

Conocimientos

Leadership

Communication

Organizational skills

Educación

BS/BA preferred

HS Diploma + 12 yrs exp

Herramientas

MS Office

WMM

Descripción del empleo

Peraton, a leading national security and IT solutions provider, seeks a Complaints/Referrals Team Lead for Medicare within SafeGuard Services (SGS). The role focuses on quality objectives, workload oversight, and case development for referrals to law enforcement or other entities.

You will mentor investigators and guide workflow development while maintaining independence within established policies. Responsibilities include managing monthly workload reviews, QC, and prioritizing referrals and