Lead Managed Care Investigator

ncdoi.gov

North Carolina, US
Base: $66,696 - $110,049; recruitment range: $66,6...
Hybrid
Medicaid program oversight
Vendor and mco compliance
Investigative support and audit activities
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.
  • This position also serves as a subject matter expert (SME) in consultations with management and team members regarding Medicaid policies and procedures.

Matching Summary

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

Salary

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

Skills & Requirements

Must-have

  • Medicaid program oversight
  • Vendor and MCO compliance
  • Investigative support and audit activities
  • Collaboration with Attorney General's Office
  • Subject matter expert on Medicaid policies

Nice-to-have

  • Technical support for staff
  • Quality assurance of work
  • Consultations with management
  • Diverse stakeholder collaboration

Key Requirements

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

Work Rights

Not specified

Tailored Resume

Cover Letter