Qualifications

Prerequisites:

• BS 5-7 Years, MS 3-5, PhD 0-2
• Must be located in one of the following states to telework: GA,SC,WV,VA, NC
• Strong investigative skills
• Strong communication and organization skills
• Experience in reviewing claims for technical requirements, performing medical review, and/or developing fraud cases
• Strong PC knowledge and skills

Essential Functions:

• Ability to communicate effectively, internally and externally
• Ability to perform research and draw conclusions
• Ability to present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government
• Ability to interpret laws and regulations
• Ability to organize a case file, accurately and thoroughly document all steps taken
• Ability to compose correspondence, reports and referral summary letters
• Ability to educate providers, provider associations, law enforcement, other contractors and beneficiary advocacy groups on program safeguard matters
• Ability to handle confidential material.
• Ability to report work activity on a timely basis.
• Ability to work independently and as a member of a team to deliver high quality work
• Ability to attend meetings, training, and conferences, overnight travel may be required
• This position may require the incumbent to appear in court to testify about work findings.

Responsibilities

SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.

Since 1999, SGS has preventedmore than$9.65 billion in inappropriate payments,consisting of nearly $5.98billion in proactively Prevented Dollars and more than $3.69 billion in Recovered Dollars. Our experience with fraud and abuse analytics has resulted in the referral of thousands of cases to law enforcement and resulted in successful criminal and civil prosecution and civil monetary penalties.

Position Overview:

The position requires the individual to use a variety of tools to initiate investigations, identify subjects and develop cases for future action, including referral to law enforcement, education, over payment recovery and other administrative actions. Will work with internal resources and external agencies to develop cases and corrective actions as well as respond to requests for data and support.

For Colorado Residents
Colorado Salary Minimum: $51,251.20 Colorado Salary Maximum:$109,574.40 The estimate displayed represents the typical salary range for this position, and is just one component of Peraton's total compensation package for employees. Other rewards may include annual bonuses, short- and long-term incentives, and program-specific awards. In addition, Peraton provides a variety of benefits to employees.