Manager, Payment Integrity - Readmissions
About This Gig
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Develop, implement and manage strategic fraud, waste and abuse activities by maintaining state and federal requirements and monitoring trends/schemes Monitor business processes and systems to assure integrity and compliance in billing and claims payment Lead teams of analysts to appropriately investigate all possible fraud, waste and abuse referrals Develop customized fraud plans to meet contract and federal requirements Develop educational materials to identify/validate waste activities as requested by the health plan and on an ad-hoc basis Respond to RFP request and implement new policies per contractual obligation Attend state/federal meetings as required by specific contracts Pre
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About the Seller
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on Himalayas