We are currently searching for a Compliance Investigator to complete investigations for Medicaid Fraud. The successful candidate will be expected to:
- Investigate allegations and issues related to Medicaid Fraud as assigned by the Director of Quality and Compliance;
- Manage caseload of investigations on fraud and complaints which include; site visits, spot checks and record reviews to comply with funding sources and RCIL’s Code of Ethics;
- Develop recommendations based on outcome of investigations and assist with the implementation of recommendations with the goal of reducing risk to the program;
- Complete investigations in a timely fashion as outlined by the Director of Quality and Compliance and to complete all necessary paperwork and logs related to investigation;
- Remain current with regulations and rules impacting Departments and Investigations, write or revise Policies and Procedures and create, conduct or identify trainings as required;
- Conduct internal audits to proactively identify areas for improvement and act to remedy any concerns; and
- Assist Director of Quality and Compliance and other Department members with design and update analytical tools such as spreadsheets, surveys databases to analyze stand and utilization.
RCIL is a civil rights organization that offers individuals with disabilities a wide range of independent living and advocacy services through the numerous programs we manage.
Who may be considered:
Successful candidates will have at least three (3) years of experience in at least several of the areas outlined above. Healthcare, disability or human service experience is strongly preferred.
A Bachelor’s Degree is preferred; a High School Diploma or equivalent is required.
Number of Vacancies: 1
Travel Required: Yes