Senior Audit & Investigations Lead

Qlarant; United States; Presencial; USD 90.000 - 130.000; Jornada completa

Descripción de la vacante

Qlarant is seeking a seasoned professional to oversee audits and investigations, evaluating cases related to Medicare fraud waste and abuse and similar compliance matters. The role includes supervising the audit process, coordinating with law enforcement and regulatory agencies, and presenting findings for administrative action or prosecution.

The ideal candidate will have a bachelor's degree, 5–7 years of relevant experience (8–11 preferred) and be certified as a Fraud Examiner or accredited

Formación

• Bachelor's degree required.
• 5–7 years of experience required; 8–11 years preferred.
• Certified Fraud Examiner or Accredited Healthcare Anti-fraud Investigator Certification preferred.

Responsabilidades

• Oversee audits/investigations and workload.
• Perform in-depth evaluation and field-level judgments for audits/investigations or cases.
• Vett providers and coordinate with agencies and law enforcement as needed.
• Supervise audit/investigation plans, ensure quality and appropriate documentation.
• Prepare and present findings for management and stakeholder meetings.
• Communicate with Data and Medical Review departments for efficient audits/investigations.
• Collaborate with other program integrity contractors as needed.
• Testify at legal or administrative proceedings as necessary.

Conocimientos

Auditing

Investigations

Leadership

Communication

Educación

Bachelor's Degree

Descripción del empleo

Qlarant is seeking a seasoned professional to oversee audits and investigations, evaluating cases related to Medicare fraud waste and abuse and similar compliance matters. The role includes supervising the audit process, coordinating with law enforcement and regulatory agencies, and presenting findings for administrative action or prosecution.

The ideal candidate will have a bachelor's degree, 5–7 years of relevant experience (8–11 preferred) and be certified as a Fraud Examiner or accredited