Senior Fraud, Waste and Abuse Specialist

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πŸ”₯ 7 minutes ago

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PACIFICSOURCE

1001 - 5000 employees

Founded 1933

Not-for-profit health plans

πŸ“‹ Description

β€’ Support the development and maintenance of the Payment Integrity and FWA program framework β€’ Develop, implement, and maintain program policies, workflows, procedures, and controls β€’ Maintain centralized tracking and reporting systems for investigations, recoveries, referrals, and regulatory activities β€’ Serve as primary liaison with CMS, MEDIC, OHA, Medicaid Fraud Units, and other oversight agencies

🎯 Requirements

β€’ Minimum of 5 years of experience in fraud, waste, and abuse (FWA) β€’ Experience analyzing healthcare claims data β€’ Knowledge of payment integrity practices β€’ Bachelor's degree in business or related field required

πŸ–οΈ Benefits

β€’ Health insurance β€’ Flexible work arrangements

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