[Hiring] Fraud Investigations Manager @Peraton

Role Description

SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse. We are looking to add a Fraud Investigations Manager to our SGS team of talented professionals.

What you'll do:

• Provide direction to a staff of investigators to identify and research issues of potential fraud, waste, and abuse.
• Oversee and assist in the development of cases for referral to law enforcement or other entities.
• Respond to requests for data and support for existing casework.
• Establish goals, objectives, and plans for the unit.
• Motivate staff and evaluate performance.
• Plan resources to address workload needs, set priorities, and report unit activity.
• Develop, administer, and control a budget.
• Administer compensation and other corporate policies.
• Recruit and develop staff.
• Participate in CMS and Law Enforcement Meetings.
• Lead a team of investigations and Lead Assessment Investigators.
• Oversee and manage workload to meet contractual requirements.
• Telework available from Maryland, District of Columbia, Pennsylvania, New Jersey, New York, Massachusetts, Connecticut, Vermont, Rhode Island, Maine, Delaware, New Hampshire.

Qualifications

• 10 years of experience, may have supervisory or lead experience.
• Proven leadership skills and in-depth knowledge of the Medicare Program as it pertains to reviewing claims and provider behavior for indications of potential fraud, waste, and abuse.
• Knowledge of Medicare requirements, laws, rules, and regulations related to payment for services billed to the Program.
• Excellent organizational and communication skills as well as strong PC skills.
• Ability to effectively work independently and as a member of a team.
• U.S. citizenship required.

Requirements

• Bachelor's degree is a plus.

Benefits

• Salary range: $80,000 - $128,000.
• Salary is determined by various factors, including but not limited to, the scope and responsibilities of the position, the individual’s experience, education, knowledge, skills, and competencies, as well as geographic location and business and contract considerations.
• Depending on the position, employees may be eligible for overtime, shift differential, and a discretionary bonus in addition to base pay.

EEO

• Equal opportunity employer, including disability and protected veterans, or other characteristics protected by law.