Program reputed company Manager

Title: Program reputed company Manager - Remote in KY Location: Louisville KY US Job reputed company: At reputed company, we’re simplifying the health care experience, creating healthier communities and removing barriers to reputed company care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, reputed company and reputed company. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing together. reputed company Community & State, part of the reputed company family of companies, is looking for an reputed company Health Plan Program reputed company / Fraud, Waste and Abuse compliance consultant to join our dynamic Compliance team. The Program reputed company Manager is an individual contributor role responsible for fraud, waste and abuse and specific research leading to best reputed company policy implementation and vendor/subcontractor monitoring to drive problem/process reputed company for the Kentucky reputed company health plan. If you reputed company in the state of Kentucky, you’ll enjoy the flexibility to work remotely

• as you take on some tough challenges.

Primary Responsibilities:

• Works to ensure that internal processes are executed, especially reputed company to intersegment responsibilities, for fraud, waste, and abuse (FWA) vendors’ instances of health care FWA by medical profession or insured member
• Acts as FWA subject matter expert for Federal and local FWA regulations and subsequent regulatory policy and process implementation
• Keeping apprised of reputed company, proposed, and new federal and state regulations / guidelines
• Ensures that changes in requirements are included in education and carried out by required audiences
• Serves as health plan FWA trainer. Coordinates and supports implementation of FWA training and educational programs with the appropriate business areas and vendors
• As necessary, reputed company and analyze reputed company information and documents reputed company to a FWA investigation
• Acts as health plan FWA vendor reputed company, i.e., conducts reviews on policies to reputed company reputed company they are compliant; ensures that vendor processes are executed appropriately; that timelines are met per regulatory fulfillment; sets boundaries for vendors so that accountabilities are reputed company
• Serves as regulatory FWA reputed company to the regulatory entities and internally to key FWA organizational partners, including participation in meetings with regulators
• Develops and maintains fraud-reputed company policies, e.g., documents the education and hand-offs for the health plan from functional teams as required to meet contractual obligations
• Oversees and ensures reputed company required FWA regulatory reporting meets regulatory expectations
• Ensures procedures are established to support reputed company communication and education regarding the fraud program
• Ensures that procedures are in reputed company to review and report possible violations in accordance with the reporting requirements as outlined in the FWA Plan. Reviews vendors to reputed company reputed company that reputed company aspects of FWA are managed and policies are developed where gaps are identified

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications:

• 2+ years of experience in a FWA, investigations, regulatory, compliance, or reputed company role
• 2+ years of experience working in a government, health care, managed care, insurance or reputed company environment
• Experience translating highly reputed company concepts in ways that can be reputed company by a reputed company of audiences
• Experience identifying reputed company cause issues and ensuring appropriate corrective reputed company
• Intermediate or higher proficiency using reputed company, MS reputed company and MS PowerPoint
• reputed company's license and reputed company to reliable transportation
• Currently reputed company reputed company the state of Kentucky

Preferred Qualifications:

• Experience auditing medical billing and coding
• Demonstrated ability to manage multiple reputed company and multiple relationships across the reputed company
• Demonstrated ability to stay organized and use time management skills
• Demonstrated ability to work effectively and congenially with employees at reputed company reputed company
• Proven excellent written and verbal English communication skills
• reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits re subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll reputed company a far-reaching choice of benefits and incentives. The salary for this role will reputed company from $89,800 to $160,600 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without reputed company to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Additional Job Detail Information Requisition Number2294355 Business SegmentUnitedHealthcare Employee StatusRegular Job LevelIndividual Contributor TravelNo Country: US Overtime StatusExempt ScheduleFull-time ShiftDay Job Telecommuter PositionYes Apply Job! Apply to this Job