What are the responsibilities and job description for the Compliance Risk Manager position at Amerihealth Caritas?
Investigation Role
The Compliance Risk Manager will play a critical role in identifying and preventing fraud, waste, and abuse across AmeriHealth Caritas.
Key Responsibilities
- Lead investigations into potential fraud, waste, and abuse, ensuring accuracy, efficiency, and compliance with legal and regulatory standards.
- Represent AmeriHealth Caritas in discussions with providers, law enforcement, and regulatory bodies, ensuring professional engagement and resolution.
Requirements
- Associate's degree required (Bachelor's preferred).
- Minimum of 3–5 years of experience conducting healthcare fraud investigations and collaborating with state, federal, and local law enforcement agencies.
- Strong knowledge of Medicaid, Medicare, and fraud-related regulatory statutes required.
