We are currently searching for a Compliance Investigator to complete investigations for Medicaid Fraud. The successful candidate will be expected to:
- Investigate allegations and issues related to Medicaid Fraud as assigned by the Director of Quality and Compliance;
- Manage caseload of investigations on fraud and complaints which include; site visits, spot checks and record reviews to comply with funding sources and RCIL’s Code of Ethics;
- Develop recommendations based on outcome of investigations and assist with the implementation of recommendations with the goal of reducing risk to the program;
- Complete investigations in a timely fashion as outlined by the Director of Quality and Compliance and to complete all necessary paperwork and logs related to investigation;
- Remain current with regulations and rules impacting Departments and Investigations, write or revise Policies and Procedures and create, conduct or identify trainings as required;
- Conduct internal audits to proactively identify areas for improvement and act to remedy any concerns; and
- Assist Director of Quality and Compliance and other Department members with design and update analytical tools such as spreadsheets, surveys databases to analyze stand and utilization.
RCIL is a civil rights organization that offers individuals with disabilities a wide range of independent living and advocacy services through the numerous programs we manage.
Who may be considered:
Successful candidates will have at least three (3) years of experience in at least several of the areas outlined above. Healthcare, disability or human service experience is strongly preferred.
A Bachelor’s Degree is preferred; a High School Diploma or equivalent is required.
Number of Vacancies: 1
Travel Required: Yes
How to Apply:
A hard copy of your resume and cover letter may also be forwarded to: RCIL, P.O. Box 210, Utica, NY 13503-0210, Attention: Recruitment or firstname.lastname@example.org.
It is the policy of RCIL to provide reasonable accommodations for qualified persons with disabilities who are employees or applicants for employment. If you need assistance or accommodations to fully participate in the interview process, please contact the HR Recruiter at 315-797-4642. Employment opportunities will not be denied to anyone because of the need to make reasonable accommodations for a person’s disability
RCIL promotes a scent/chemical free environment. To support this effort, we ask that all applicants refrain from wearing scented products while in its office.
RCIL is an equal opportunity employers. All persons—including people with disabilities; elders; women; and people of racial and ethnic minority—are encouraged to apply.