Medicare/Medicaid Task Order Manager

**PLEASE APPLY TO THIS POSITION AT WWW.FCSO.COM**

**THIS POSITION WILL BE LOCATED IN THE WESTERN UNITED STATES**

First Coast Service Options, Inc. (FCSO) is a wholly owned subsidiary of the largest health insurance company in the state of Florida. Our exciting new business venture will provide audit, oversight, anti-fraud, and waste and abuse monitoring of Medicare Parts A, B, and C, the Medicare Prescription Drug Benefit (Part D), Durable Medical Equipment, Home Health and other aspects of the Medicare and Medicaid program for several western states. As a part of Florida's most successful health insurance company, we are an equal employment opportunity employer and are committed to excellence in all that we do.

JOB DUTIES:

Job duties include but are not limited to:

*Lead and manage a team of investigators and medical personnel dedicated to fighting fraud, waste, and abuse of Medicare/Medicaid dual eligibles
*Plan, execute, manage, and monitor all operational requirements of the operation
*Hire, train, and retain qualified staff
*Oversee the performance of the computerized matching and analysis of Medicare and Medicaid data to detect and develop potential fraud cases
*Ensure that detailed statistical analysis and trending are performed and potential fraud cases are developed for referral to the appropriate healthcare oversite or law enforcement agency
*Build and maintain effective partnership with state agencies to reduce potential fraud, waste, and abuse in Medicare

JOB REQUIREMENTS:

*Bachelor's degree plus a master's degree or 4 additional years of related work experience in lieu of mater's degree
*Minimum 10 years of professional experience with at least three years as a manager responsible for managing complex systems and work flows
*Minimum 3 years of Medicare experience with experience in Program Integrity preferred. Healthcare fraud investigative experience may be substituted for Medicare experience
*Minimum 3 years of law enforcement background or investigative experience
*Certified Fraud Examiner (CFE)
*Medicaid experience preferred

**If you are an experienced fraud and abuse analyst, investigator, auditor, or have a background in Medicare or Medicaid administration and have an interest in exploring other career opportunities with our exciting company, we invite you to send your resume to careers@fcso.com.**