UNKNOWN

FEED

Due to the nature of this work, the Investigator I must be able to work independently and complete tasks in a timely manner and work effectively within short deadlines, including any investigation deadlines set by statute or regulation. This position requires a Bachelors from an accredited college or university as recognized by the United States Department of Education and/or the Council on Higher Education Accreditation (CHEA).

YEAR

University of Nevada Las Vegas

Investigator I, Equal Employment & Title IX, UNLV Office of Equal Employment and Title IX [R0153698]

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FULL_TIME

OTHER

Complies with the Veterans Affairs Community Care Network (CCN) and TRICARE T-5 contracts; DHA and TRICARE program guidelines and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, Military members and family (as warranted), providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals. The PI Investigator t is responsible for the identification, analysis, case development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA), the Healthcare Finance Administration (HCFA) and the Department of Defense, Defense Health Agency for the TRICARE program; requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).

TriWest Healthcare Alliance

Program Integrity Investigator

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To apply directly, CLICK HERE , (Application typically takes 5-10 min to complete) or paste this link into your browser: https://www.joinsecretservice.com/jobs/criminal-investigator-special-agent/?utm_source=elevate . As a criminal Investigator (Special Agent), you'll receive paid training, develop investigative skills, and take on work with real-world impact.

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