Manager Special Investigation Unit (Hybrid - Troy, MI) - Health Alliance Plan
EDUCATION/EXPERIENCE REQUIRED:
- Bachelor's degree required in related field.
- Related and relevant experience may be considered in lieu of academic requirements. Related experience is defined as ten (10) years of progressive investigation operational experience.
- Minimum of five (5) years of experience conducting comprehensive health plan, health care, and health insurance investigations, and interacting with state, federal, and local law enforcement agencies.
- At least three (3) years of Healthcare SIU supervisory experience.
- Experience working with Medicare and Medicaid programs.
- Experience developing program integrity and cost containment programs, specifically with Program Integrity reporting requirements and implementing best practices.
- Experience of Cost Containment and recoveries and overpayments related to SIU/FWA Programs.
CERTIFICATIONS/LICENSURES REQUIRED:
- Accredited Healthcare Fraud Investigator certification required.
Additional Details
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.
Overview
Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services – from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford’s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation’s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers.
Benefits
The health and overall well-being of our team members is our priority. That’s why we offer support in the various components of our team’s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.
Equal Employment Opportunity/Affirmative Action Employer
Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is
committed to the hiring, advancement and fair treatment of all individuals without regard to
race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,
weight, marital status, family status, gender identity, sexual orientation, and genetic information,
or any other protected status in accordance with applicable federal and state laws.