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Assistant Director of Medicare Advantage Audit and Fraud Compliance
DescriptionAs the Assistant Director of Medicare Advantage Audit and Fraud Compliance, you’ll play a crucial role in safeguarding our health plan resources and upholding regulatory standards.In this role, you’ll develop and execute strategies to detect and address non-compliance, Fraud, Waste, and Abuse (FWA) within our Medicare Advantage and Prescription Drug programs. Leading a team of managers, you’ll oversee internal audits, FWA detection through data mining, and ensure compliance with CMS and DMHC regulations.Key responsibilities include:Oversee aspects of the Medicare Advantage Prescription Drug Anti-Fraud, Special Investigations Unit (SIU), and Audit Programs through subordinate m
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