**This position is 100% remote.**

**Scope of Responsibilities**

+ Conduct investigations of Providers, Representatives, Employees, Members, contracted groups and others
+ Compile data into written reports: collect, utilize & interpret data obtained from a variety of reports and other sources, thereby identifying & documenting questionable patterns related to operation, and other practices which merit further investigation
+ Investigations may be of a more complex nature i.e., multiple allegations; Medicaid and Medicare investigations or investigations involving extensive research, income verifications, and other criteria for eligibility
+ Research investigations; prepare, review and edit investigation reports for submission to AVP, SIU and Marketing Incidents Committee
+ Present relevant investigative findings: prepare and deliver presentation summaries to the Marketing Incidents Committee, and/or other groups as needed
+ Log investigations, ensure accu...