Senior Fraud Investigations Manager — Remote

Peraton; Northern (KY); Hybrid; USD 80,000 - 128,000; Full time

Job summary

Peraton is seeking a Fraud Investigations Manager to lead the SGS team in detecting fraud, waste, and abuse. The role involves directing investigators, overseeing case development for referrals, and supporting data requests for active investigations.

Requirements include 10 years of experience, Medicare program knowledge, strong leadership, and the ability to work independently within a dynamic team. Telework is available from multiple states across the U.S.

Qualifications

• 10 years of experience with potential supervisory or lead roles.
• Proven leadership skills and Medicare program knowledge in claims reviews.
• Knowledge of Medicare requirements and providers' billing rules.
• Excellent organizational and communications skills; strong PC skills.
• Ability to work independently and as part of a team.
• US citizenship required.

Responsibilities

• Provide direction to investigators to identify and research fraud, waste and abuse.
• Oversee development of cases for referral to law enforcement or other entities.
• Respond to data requests and support for casework.
• Establish 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.
• Participate in CMS and law enforcement meetings.
• Lead a team of investigations and Lead Assessment Investigators.
• Oversee workload to meet contractual requirements.

Skills

Leadership skills

Medicare knowledge

Organizational skills

Communication skills

Independent worker

Team player

US citizenship

Education

Bachelor's degree

Job description

Peraton is seeking a Fraud Investigations Manager to lead the SGS team in detecting fraud, waste, and abuse. The role involves directing investigators, overseeing case development for referrals, and supporting data requests for active investigations.

Requirements include 10 years of experience, Medicare program knowledge, strong leadership, and the ability to work independently within a dynamic team. Telework is available from multiple states across the U.S.