Manager, Special Investigative Unit/ Program Integrity / CPC

This role involves managing a team of Special Investigative Unit Investigators across multiple states, reporting findings to government and regulatory agencies, and leading monthly FWA subcommittee meetings. The position requires extensive interaction with internal departments, providers, and government agencies to review and propose updates to health plan rules and policies related to fraud, waste, and abuse. It also entails providing compliance advice and assisting with organizational change and compliance interpretation within a healthcare payer environment.