NC Medicaid Office of Compliance and Program Integrity (OCPI)
Unknown, North Carolina, US
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
This senior management position is responsible for establishing and executing effective oversight protocols of the Special Investigations Units of the State’s contracted health plans
Job Summary
This senior management position is responsible for establishing and executing effective oversight protocols of the Special Investigations Units of the State’s contracted health plans.
The role will work in partnership with DHB Provider Operations and DHB Clinical Policy to facilitate the adequate implementation of provider policies and practices.
The State of North Carolina offers excellent comprehensive benefits, including health insurance, retirement plans, and paid leave.
Matching Summary
This senior management position 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
Managed care plan monitoring
Collaboration with legal counsel
Performance measurement and reporting
Nice-to-have
Data insights to actionable strategies
Criminal or civil proceedings support
Fostering collaboration across stakeholders
Building effective partnerships
Coaching staff and managing performance
Key Requirements
Master's degree and 5 years experience (3 supervisory)
Bachelor's degree and 7 years experience (3 supervisory)
Equivalent combination of education and experience