Senior Audit & Investigation Lead

Qlarant; New York (NY); Sur place; USD 90 000 - 130 000; Plein temps

Résumé du poste

Qlarant is a not-for-profit organization delivering quality health and human services programs across public and private sectors. The role oversees audits/investigations related to Medicare fraud, waste and abuse and guides field-level judgments on referrals to agencies or law enforcement.

The position requires leadership in project management, collaboration with data and medical review teams, and the ability to present findings.

Qualifications

• Minimum Bachelor's Degree required.
• 5–7 years of audit/investigation experience.
• Certified Fraud Examiner or Accredited Healthcare Anti-fraud Investigator Certification preferred.

Responsabilités

• Oversees audits/investigations workload and assigns to staff.
• Supervises vetting with appropriate agencies and law enforcement.
• Reviews audit/investigation plans, conducts file reviews, and ensures data entry into tracking systems.
• Leads audit/investigation projects and documents findings for management.
• Testifies at proceedings and communicates results to stakeholders.

Connaissances

Audits & investigations

Supervisory experience

Stakeholder communication

Interviews

Formation

Bachelor's degree

Outils

Case tracking systems

Description du poste

Qlarant is a not-for-profit organization delivering quality health and human services programs across public and private sectors. The role oversees audits/investigations related to Medicare fraud, waste and abuse and guides field-level judgments on referrals to agencies or law enforcement.

The position requires leadership in project management, collaboration with data and medical review teams, and the ability to present findings.