The Managed Care Oversight Investigator conducts inquiries and investigations into suspected fraud, waste, and abuse within the Medicaid behavioral and physical health provider network
Job Summary
The Managed Care Oversight Investigator conducts inquiries and investigations into suspected fraud, waste, and abuse within the Medicaid behavioral and physical health provider network.
This role supports the integrity of state healthcare expenditures and promotes program compliance by ensuring compliance with managed care regulations, contractual obligations, and program integrity standards.
The State of North Carolina offers excellent comprehensive benefits, including health insurance, retirement plans, paid leave, and paid parental leave.
Matching Summary
The Managed Care Oversight Investigator conducts inquiries and investigations into suspected fraud, waste, and abuse within the Medicaid behavioral and physical health provider network.
Master's degree and two years of related experience OR Bachelor's degree and four years of related experience OR equivalent combination of education and experience
Ability to interpret and apply state and federal regulations
Experience performing investigations to establish Fraud, Waste, and Abuse credibility