Investigator, Special Investigation Unit
at Providence Health Plan
Washington State, Washington, USA -
Start Date | Expiry Date | Salary | Posted On | Experience | Skills | Telecommute | Sponsor Visa |
---|---|---|---|---|---|---|---|
Immediate | 17 Nov, 2024 | USD 43 Hourly | 18 Aug, 2024 | 2 year(s) or above | Chiropractic,Powerpoint,Power Bi,Dc,Law Enforcement,Statistics,Agile,Medicine,Analytics,Tableau,Communication Skills,Alteryx,Attorneys | No | No |
Required Visa Status:
Citizen | GC |
US Citizen | Student Visa |
H1B | CPT |
OPT | H4 Spouse of H1B |
GC Green Card |
Employment Type:
Full Time | Part Time |
Permanent | Independent - 1099 |
Contract – W2 | C2H Independent |
C2H W2 | Contract – Corp 2 Corp |
Contract to Hire – Corp 2 Corp |
Description:
REQUIRED QUALIFICATIONS FOR THIS POSITION INCLUDE:
- Bachelor’s Degree -OR- a combination of equivalent education and experience
- 5+ years coding experience at a healthcare provider, facility or health insurance company
- 2+ years fraud and abuse audit experience at a health plan, health insurance company, healthcare provider, facility or other relevant healthcare environment
- Project management experience, education program development experience and group presentation experience
- Experience in use of data mining software/tools
PREFERRED QUALIFICATIONS FOR THIS POSITION INCLUDE:
- Clinical background such as Registered Nurse (RN), Doctorate of Medicine (MD), or Doctor of Chiropractic (DC)
- Current certification as Certified Coding Professional (CPC)
- Current certification in health care fraud investigation, such as Accredited Healthcare Fraud Investigator (AHFI), Certification as an Internal Auditor (CIA), Healthcare Compliance certification (CHC), or equivalent
- Certification in Project Management or Agile (PMP, CSM, CSPO)
- Basic understanding of statistics and data analytics
- Basic understanding of analytics software (e.g.: SQL, Power BI, MS Access, Tableau, Alteryx) or a demonstrated interest in learning analytics software
- Advanced understanding of MS Excel and PowerPoint
- Professional communication skills, representing the SIU in verbal and written communications with executives, law enforcement, regulators, attorneys, physicians, members, etc.
Responsibilities:
- This position is affiliated with Providence Health Plan and will be tied to a location and compensation range in Beaverton, Oregon
Providence Health Plan welcomes 100% remote work for applicants who reside in one of the following States:
- Washington
- Oregon
- California
REQUIREMENT SUMMARY
Min:2.0Max:5.0 year(s)
Hospital/Health Care
Pharma / Biotech / Healthcare / Medical / R&D
Health Care
Graduate
Proficient
1
Washington State, USA