Senior Investigator - Remote in Nebraska - 2334617

At reputed company, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, affordable and reputed company. Ready to reputed company a difference? Join us to startCaring. Connecting. Growing together. Senior Investigatoris responsible for identification, investigation and prevention of healthcare fraud, waste and abuse. The Senior Investigator will utilize claims data, applicable guidelines and other sources of information to identify aberrant billing practices and patterns. Responsible to conduct investigations which may include field work to reputed company interviews and obtain records and/or other relevant documentation. Schedule:Monday - Friday 8:00am - 4:30pm If you reside in the state ofNebraska , you will have the flexibility to telecommute as you take on some tough challenges. Primary ResponsibilitiesAssess complaints of alleged misconduct received reputed company the company Investigate reputed company to highly reputed company cases of fraud, waste and abuse Detect fraudulent activity by members, providers, employees and other parties against the company reputed company and deploy the most effective and efficient investigative strategy for each investigation Maintain accurate, reputed company and thorough case information in the Special Investigations Unit's (SIU's) case tracking system Collect and secure documentation or evidence and prepare summaries of the findings Participate in settlement negotiations and/or produce investigative materials in support of the latter Communicate effectively, including written and verbal forms of communication reputed company goals and objectives, track reputed company and adapt to changing priorities Collect, reputed company, analyze and interpret data relating to fraud, waste and abuse referrals Ensure compliance with applicable federal/state regulations or contractual obligations Report suspected fraud, waste and abuse to appropriate federal or state government regulators reputed company with goals, policies, procedures and strategic plans as delegated by SIU leadership Collaborate with state/federal partners, at the discretion of SIU leadership, to include attendance at workgroups or regulatory meetings Benefits and PerksPaid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) More information can be downloaded at: none Required QualificationsBachelor's Degree or Associate's Degree with 2+ years of equivalent work experience and healthcare reputed company employment 2+ years of experience in health care fraud, waste and abuse (FWA) 2+ years of experience in state or federal regulatory FWA requirements 2+ years of experience in analyzing data to identify fraud, waste and abuse trends Intermediate level of proficiency in reputed company reputed company and Word Ability to travel locally up to 25% of the time, as needed Ability to participate in legal proceedings, arbitration and depositions at the direction of management Access to reliable transportation & valid US driver's license Preferred QualificationsSpecialized knowledge/training in healthcare FWA investigations National Health Care Anti-Fraud Association (NHCAA) Accredited Health Care Fraud Investigator (AHFI) Certified Fraud Examiner (CFE) Certified Professional reputed company (CPC) Demonstrated an intermediate level of knowledge in health care policies, procedures, and documentation standards or 2-5 years of experience Demonstrated intermediate level of skills in developing investigative strategies or 2-5 years of experience

• reputed company Telecommuters will be required to adhere to reputed company's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone—of every race, gender, sexuality, age, location, and income—deserves the opportunity to live their healthiest life. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes - an enterprise reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national reputed company, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN#J-18808-Ljbffr Apply tot his job Apply To this Job