Lead Managed Care Investigator

ncosc.gov

North Carolina, US
Recruitment range: $66,696 - $85,717; grade range:...
Hybrid
Managed care organizations oversight
Medicaid program compliance
Investigative techniques
The Lead Managed Care Investigator plays a critical role in ensuring quality and compliance within the Medicaid program

Job Summary

  • The Lead Managed Care Investigator plays a critical role in ensuring quality and compliance within the Medicaid program.
  • This position is responsible for providing oversight of vendors and Managed Care Organizations (MCOs), supporting investigations, and engaging in audit activities.
  • Position is eligible for a hybrid-teleworking schedule to include weekly onsite work hours.

Matching Summary

The Lead Managed Care Investigator plays a critical role in ensuring quality and compliance within the Medicaid program.

Salary

Recruitment Range: $66,696 - $85,717; Grade Range: $66,696 - $110,049; Benefits: Not specified

Skills & Requirements

Must-have

  • Managed Care Organizations oversight
  • Medicaid program compliance
  • Investigative techniques
  • Audit activities
  • Quality assurance

Nice-to-have

  • Subject matter expert
  • Collaboration with stakeholders
  • Technical support
  • Policy interpretation

Key Requirements

  • Licensed Registered Nurse in North Carolina
  • Two years of clinical experience
  • Equivalent combination of education and experience

Work Rights

Not specified

Tailored Resume

Cover Letter