Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country.
Qlarant has an immediate opening for a Healthcare Fraud Lead Investigator - Medicare to provide supervision and mentoring to a team of Investigators. In addition to your exceptional healthcare fraud investigation knowledge and experience, well qualified candidates will possess prior supervisory and leadership experience. The position may be worked remotely.
Job Summary: This position oversees investigations and investigation workload. Independently performs in-depth evaluation and makes field level judgments related to investigations of potential Medicare fraud waste and abuse investigations or cases compliance cases that meet established criteria for referral to the Centers for Medicare & Medicaid for administrative action or to the OIG for criminal action.
Essential Duties and Responsibilities:
Supervisory Responsibilities
Supervises staff in the operational area. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
To perform the job successfully, an individual should demonstrate the following competencies:
Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data.
Problem Solving - Gathers and analyses information skillfully; Identifies and resolves problems.
Written Communication - Writes clearly and informatively; Able to read and interpret written information.
Judgment - Supports and explains reasoning for decisions.
Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities.