Compliance Program Integrity Manager

Job Summary

A company is looking for a Manager, Program Integrity - Compliance.

Key Responsibilities

• Manage compliance with Federal and State laws related to program integrity and disclosure requirements
• Serve as the primary subject matter expert on fraud, waste, and abuse
• Coordinate audit documentation and develop internal policies and procedures

Required Qualifications

• Bachelor's degree in Business, Healthcare, Criminal Justice, or a related field, or equivalent experience
• 4+ years of experience in medical claim investigation, compliance, or fraud and abuse
• Thorough knowledge of medical terminology
• Previous experience in a managed care environment preferred
• Knowledge of Microsoft Excel, medical coding, and claims processing preferred