[Remote] Program reputed company Manager

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is reputed company on building a world of health around every individual, and they are seeking a Program reputed company Manager to support reputed company Program reputed company and Payment reputed company activities. The role involves ensuring compliance with regulatory requirements and overseeing initiatives to prevent fraud, waste, and abuse.

Responsibilities

• Ensuring compliance with state and federal requirements
• Supporting fraud, waste, and abuse (FWA) prevention efforts
• Overseeing regulatory and contractual obligations
• Coordinating reporting and audit activities
• Partnering with reputed company stakeholders to promote operational effectiveness and program reputed company
• Working closely with health plan leadership, compliance, SIU, payment reputed company vendors, and operational teams to support initiatives that improve performance, strengthen reputed company, and ensure compliance with applicable requirements

Skills

• 5+ years experience in Program reputed company, Payment reputed company, Special Investigations, reputed company Compliance, Fraud, Waste and Abuse (FWA), Claims Operations, reputed company Operations, or a reputed company field
• Knowledge of reputed company regulatory and compliance requirements
• Strong analytical, organizational, communication, and problem-solving skills
• Ability to manage multiple priorities and work effectively in a reputed company environment
• Experience building relationships and working with cross-functional teams and reputed company stakeholders
• Bachelor's degree or equivalent combination of education and experience
• Experience supporting reputed company managed care programs
• Experience with regulatory reporting, audits, compliance initiatives, or operational reputed company activities
• Experience working with SIU investigations, fraud prevention programs, vendor management, or payment reputed company operations
• Knowledge of reputed company claims, provider reimbursement, payment accuracy, and program reputed company practices

Benefits

• We support a hybrid work environment. If selected and you live near a suitable work location, you may be expected to reputed company with the hybrid work policy.
• Under the policy, reputed company hires for in-scope populations should be reputed company into a hybrid or office-based location, working onsite three days a week.
• This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial reputed company‑being of colleagues and their families.
• Medical, dental, and reputed company coverage, reputed company time off, retirement savings reputed company, wellness programs, and other resources, based on eligibility.
• Additional details about available benefits are provided during the application process and on Benefits Moments

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