Telecommute ACD Program Integrity Lead

Location: Alabama, Arizona, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Kentucky, Louisiana, North Carolina, Ohio, South Carolina, Texas, Wisconsin

Compensation: To Be Discussed

Staff Reviewed: Wed, Jun 09, 2021

This job expires in: 18 days

Job Category: Investigations

Remote Level: 100% Remote

Weekly Hours: Full Time

Employer Type: Employer

Career Level: Experienced

Education Level: Bachelors

Job Summary

A health insurance company has an open position for a Telecommute ACD Program Integrity Lead.

Must be able to:

  • Ensure performance compliance with all ACD requirements
  • Research compliance issues to determine root cause and the best course of action
  • Notify leadership as necessary on the need for functional strategies to address significant issues

Applicants must meet the following qualifications:

  • 3 plus years of healthcare fraud investigation experience
  • 2 plus years of technical experience with SQL server and integration services
  • TRICARE knowledge and experience
  • Experience in healthcare or in a managed care setting
  • Experience with Microsoft Office products for business presentations

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