Associate Director, Provider Compliance

North Carolina Department of Health and Human Services

Unknown, North Carolina, US
Base: $100,641 - $107,816; bonus/equity: not speci...
Hybrid
Provider fraud, waste, and abuse detection
Medicaid managed care oversight
Provider audit and investigation procedures
The Associate Director, Provider Compliance is responsible for establishing and executing effective oversight protocols of Special Investigations Units and developing procedures for provider audits and investigations

Job Summary

  • The Associate Director, Provider Compliance is responsible for establishing and executing effective oversight protocols of Special Investigations Units and developing procedures for provider audits and investigations.
  • This role will ensure NC Medicaid managed care organizations have and follow sound principles and practices for conducting provider audits, investigations and monitoring.
  • The position is eligible for a hybrid-teleworking schedule to include weekly onsite work hours and offers comprehensive state benefits.

Matching Summary

The Associate Director, Provider Compliance is responsible for establishing and executing effective oversight protocols of Special Investigations Units and developing procedures for provider audits and investigations.

Salary

Base: $100,641 - $107,816; Bonus/Equity: Not specified; Benefits: Comprehensive state benefits

Skills & Requirements

Must-have

  • Provider fraud, waste, and abuse detection
  • Medicaid managed care oversight
  • Provider audit and investigation procedures
  • Federal and state regulations compliance
  • Cross-functional collaboration with legal and analytics

Nice-to-have

  • Personnel administration and development
  • Vendor relationship management
  • Data-driven investigative strategies
  • Public sector healthcare experience

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
  • Experience in detecting and preventing fraud, waste, and abuse
  • Experience leading complex investigations
  • Demonstrated leadership experience managing large teams

Work Rights

Not specified

Tailored Resume

Cover Letter