Responsibilities

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:

This position entails providing direction to a staff of investigators to identify and research issues of potential fraud, waste and abuse.  Primary responsibilities include oversight and assistance to the development of cases for referral to law enforcement or other entities and responding 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 polices
• Recruit and develop staff
• Participation in CMS and Law Enforcement Meetings
• Lead a team of investigations and Lead Assessment Investigators
• Oversee and manage workload to meet contractual requirements

Qualifications

Basic Qualifications:

• 10 years of experience, may have supervisory or lead experience
• This position requires 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 the Program.
• Excellent organizational and communications skills as well as strong PC skills.
• Ability to effectively work independently and as a member of a team
• US citizenship required
• Telework is available from Maryland, District of Columbia, Pennsylvania, New Jersey, New York Massachusetts, Connecticut, Vermont, Rhode Island, Maine, Delaware, New Hampshire

 

Target Salary Range$104,000 - $166,000. This represents the typical salary range for this position. 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.