Apr 12, 2025
Cook Children's Health Care System
Location: Calmont Operations Building Department: Compliance Shift: First Shift (United States of America) Standard Weekly Hours: 40 Summary: Responsible for supporting the prevention, detection, investigation, reporting, and when appropriate, recovery of money related to Texas Medicaid Provider fraud, waste, and abuse within Cook Childrens Health Plans provider network, members, and staff. Duties include generating accurate and timely analysis and reports to support the SIU preliminary investigation and medical record audit to identify fraud, waste, and abuse. The position may also work with other internal departments, including Compliance, Corporate Legal Counsel, and the Health Plan Medical Director for additional oversight and compliance with Texas Medicaid Fraud, Waste and Abuse regulatory guidelines. Responsibilities include importing, transforming, and validating data from the SIU team for decision-making...
Professional Diversity Network
Fort Worth, TX, USA
Full-Time