Baltimore, MD30+ days ago
Collaborate with investigative teams to correlate review findings with appropriate actions, e.g., provider education through original complex and technical letters, meeting and negotiating with providers, recoveries of monies, recommending network de-selection referrals to State and/or Federal Agencies to effect changes in the providers facilitys practice. When assigned, acts as liaison/consultant to agencies outside the corporation, developing cases in cooperation with Boards of Medicine, local medical societies, and State and/or Federal agencies, including the Office of the Inspector General, Office of Personnel Management, and Federal Bureau of Investigations.