CPC Certified Investigative Unit Manager

Job Summary

Managing a team of Special Investigative Unit (SIU) Investigators, the full-time remote CPC Certified Investigative Unit Manager will oversee compliance efforts related to fraud, waste, and abuse while interacting with various internal departments and regulatory agencies.

Key responsibilities:

• Manage a team of SIU Investigators across multiple states
• Report findings to government and regulatory agencies
• Review and propose updates to health plan rules and policies regarding fraud, waste, and abuse

Required qualifications:

• Bachelor's degree required
• Certified Professional Coder (CPC) certification required
• 2 years of supervisory experience required
• 5 years of coding experience required
• Prior leadership experience managing a pre-pay review team in a healthcare payer environment required