Base: $100,641 - $107,816; bonus/equity: not speci...
Hybrid
Provider fraud, waste, and abuse detection
Oversight of special investigations units
Provider audit and investigation procedures
The Associate Director, Provider Compliance is responsible for establishing and executing effective oversight protocols of the Special Investigations Units of the State’s contracted health plans
Job Summary
The Associate Director, Provider Compliance is responsible for establishing and executing effective oversight protocols of the Special Investigations Units of the State’s contracted health plans.
This position will ensure NC Medicaid managed care organizations have and follow sound principles and practices for conducting provider audits, investigations and monitoring.
The State of North Carolina offers excellent comprehensive benefits, including health insurance, retirement plans, and paid leave.
Matching Summary
The Associate Director, Provider Compliance is responsible for establishing and executing effective oversight protocols of the Special Investigations Units of the State’s contracted health plans.
Salary
Base: $100,641 - $107,816; Bonus/Equity: Not specified; Benefits: Comprehensive state benefits package
Skills & Requirements
Must-have
Provider fraud, waste, and abuse detection
Oversight of Special Investigations Units
Provider audit and investigation procedures
Medicaid managed care compliance
Collaboration with legal counsel and law enforcement
Nice-to-have
Data insights into actionable strategies
Fostering collaboration across stakeholders
Coaching staff and managing performance
Familiarity with NC contracting processes
Key Requirements
Master's degree and 5 years of experience (3 supervisory)
Bachelor's degree and 7 years of experience (3 supervisory)
Equivalent combination of education and experience