UNKNOWN

FEED

Utilize clients fraud detection solution to identify post-payment or pre-payment opportunities for investigation as well as other applications to perform data mining or track investigative results. Integrity Advantage is a small woman owned business serving health payers and other entities challenged with the detection, investigation and prevention of healthcare fraud, waste and abuse (FWA).

Levels (Investigator, Sr. Investigator, etc) will depend on experience and qualifications.Integrity Advantage is a small woman owned business serving health payers and other entities challenged with the detection, investigation and prevention of healthcare fraud, waste and abuse (FWA). We are growing and looking for dynamic, confident and skilled individuals who want to grow with us. Our current need is a healthcare FWA investigator to assist our clients in identifying potential allegations of fraud, conducting investigations and assisting in the recovery process. This is a client facing position, so phenomenal customer service skills are key to being hired for this position.Essential daily duties and responsibilities:<ul><li>Perform timely, thorough and well documented investigations</li><li>Maintain, organize and prioritize leads and investigations of varying complexity</li><li>Gather evidence, research and other information to substantiate or refute allegations</li><li>Utilize clients fraud detection solution to identify post-payment or pre-payment opportunities for investigation as well as other applications to perform data mining or track investigative results</li><li>Support multiple clients with Medicaid, Medicare, Federal Employee and Commercial lines of business</li><li>Communicate status updates to clients as appropriate</li><li>Prepare well written investigative reports including any findings from medical record reviews</li><li>Knowledgeable in using RAT-STATS for statistically valid random sampling</li><li>Ability to provide support to clients for law enforcement referrals, settlement or legal proceedings</li><li>Support other initiatives, as required</li></ul>Required Education / Licenses / Certifications:<ul><li>Bachelors degree</li><li>Accredited Healthcare Fraud Investigator (AHFI) preferred</li></ul>Experience:<ul><li>At least 2 years of healthcare claims investigation experience</li></ul>Knowledge, Skills & Abilities:<ul><li>Integrity, accountability and confidence</li><li>Demonstrated ability to create solutions to problems</li><li>Ability to travel for training events, conferences and provide onsite assistance to clients, when needed (appropriate notice will be provided)</li><li>Excellent grasp of MS Word, Excel and PowerPoint</li><li>Quickly adapt to different anti-fraud technology solutions including ad-hoc query, analytical and case management applications</li><li>Knowledge of federal and state guidelines as well as ICD, CPT, HCPCS, DRG, and rev codes</li><li>Ability to demonstrate professionalism as well as written and oral communication skills</li><li>Ability to work independently within a remote team, under minimal supervision</li></ul>Benefits:<ul><li>401(k)</li><li>Dental insurance</li><li>Health insurance</li><li>Paid time off</li><li>Professional development assistance</li><li>Vision insurance</li></ul>Education:<ul><li>Bachelor's Degree</li></ul>License/Certification:<ul><li>AHFI or CFE or other industry certification</li></ul>

HireAligned

Healthcare Fraud Investigator at Integrity Advantage (Remote)

Case Management

Communication Skills

Conferences

Current Procedural Terminology (CPT)

Customer Relations

Customer Support/Service

Data Mining

Diagnosis-Related Group (DRG)

Establish Priorities

Fraud Investigation

Healthcare

Healthcare Common Procedure Coding System (HCPCS)

International Classification of Diseases (ICD)

Investigative Reports

Law Enforcement

Litigation Settlement

Medicaid

Medical Records

Medicare

Microsoft Excel

Microsoft PowerPoint

Microsoft Word

Presentation/Verbal Skills

Query Analysis

Small Business

Statistical Sampling

Time Management

Vision Plan

Willing to Travel

Writing Skills

dstribute

You have experience managing projects or programs within software development organizations preferably with platform or infrastructure teamsYou bridge the gap between strategic priorities and team-level execution helping teams focus on what matters mostYou excel at influencing stakeholders across levels from engineers to executives and thrive in environments requiring change management and organizational alignmentYou have a working understanding of software development lifecycle SDLC and product management processes and are comfortable collaborating with technical stakeholdersYou enjoy technical conversations and can facilitate decisions even if youre not the technical expert in the roomYou champion teams creating quality products and focus teams on delivering measurable value to users whether internal stakeholders or external clientsYou are detail orientedExperience managing projects requiring industry-wide coordination and stakeholder alignment. PMP or PgMP certifications preferred but not requiredBenefits Comprehensive Benefits Including Medical Dental Vision & Retirement Savings PlanRestricted Stock UnitsFlexible Paid Time Off & HolidaysLife InsuranceTuition ReimbursementMentorship OpportunitiesTraining & DevelopmentRemote work118000 - 148000 a yearThis compensation range takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill set experience training licensure certifications geography and other business and organizational needs.

Program Manager RemoteRemote OR Remote WA Remote NY Remote CO Remote TXProduct Management Full-time RemoteApply for this jobAbout UsDigimarc NASDAQ DMRC is building the trust layer for the modern world. As AI accelerates how we produce share and interact with the world the risks of fraud counterfeiting and misinformation are growing exponentially. Our innovative highly scalable and ultra-secure solutions make it possible for consumers businesses and intelligent systems to instantly verify whats real protect what matters and transact with confidence. Recognized in Gartners 2025 Hype Cycle as a key vendor in the emerging TrustOps category Digimarcs solutions for loss prevention authentication and digital are built to counter the speed and sophistication of todays AI-enabled threats. Trusted by the worlds central banks to deter the counterfeiting of global currency we exist to protect truth in every interaction spanning both the physical and digital worlds. Learn more at Digimarc.com. ABOUT THE ROLEWe are seeking a Program Manager that will report directly to our Chief Product Officer with a proven track record of success in launching programs from the ground up.This role requires 25 travel.WHAT YOU WILL DO… Manage complex programs and large projects across the full product lifecycle ensuring alignment with strategic goals and maximizing team outcomes.Deliver projects on time within budget and at quality standards through strong communication scope management risk mitigation and stakeholder engagement.Optimize resources and processes by developing new workflows identifying cost savings and driving continuous efficiency improvements.Lead cross-functional execution by sequencing dependencies aligning priorities and collaborating with product engineering and business teams.Define goals success criteria and program metrics guiding prioritization and structured decision-making that balances technical and business needs.Track and communicate program performance surfacing risks blockers and organizational friction while supporting rollout of new systems and processes.Organize and facilitate highly effective meetings for a wide range of audiences including executive leadership team all company roadmap updates cross-departmental updates and meetings across your product areaPartner with Legal Marketing Sales and other teams to ensure product readiness and successful Go-To-Market launches.Facilitate effective meetings at all levels support program-level process improvements and embody Digimarcs values of collaboration curiosity and courage.Manage complex business-focused projects in addition to technical initiatives.Lead customer-facing projects involving multiple internal and external stakeholders.WHAT WE ARE LOOKING FOR… 5 years Program Management ExperienceExperience with JIRA SharePoint Microsoft Suite Teams Confluence Smartsheet or similar PMO tools including reporting tools e.g. Tableau PowerBIYou thrive in ambiguity applying strategic thinking and a sense of urgency to bring clarity and momentum to complex challengesExperience with Agile methodologies portfolio management tools and executive-level reporting is required.You have experience managing projects or programs within software development organizations preferably with platform or infrastructure teamsYou bridge the gap between strategic priorities and team-level execution helping teams focus on what matters mostYou excel at influencing stakeholders across levels from engineers to executives and thrive in environments requiring change management and organizational alignmentYou have a working understanding of software development lifecycle SDLC and product management processes and are comfortable collaborating with technical stakeholdersYou enjoy technical conversations and can facilitate decisions even if youre not the technical expert in the roomYou champion teams creating quality products and focus teams on delivering measurable value to users whether internal stakeholders or external clientsYou are detail orientedExperience managing projects requiring industry-wide coordination and stakeholder alignment.PMP or PgMP certifications preferred but not requiredBenefits Comprehensive Benefits Including Medical Dental Vision & Retirement Savings PlanRestricted Stock UnitsFlexible Paid Time Off & HolidaysLife InsuranceTuition ReimbursementMentorship OpportunitiesTraining & DevelopmentRemote work118000 - 148000 a yearThis compensation range takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill set experience training licensure certifications geography and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled.Our CultureWe are a team of problem-solvers united by our companys immense potential to help solve complex challenges.We align to the following Digimarc core valuesCollaborative - Stronger togetherWe embrace diverse perspectives and harness our collective talent to realize our full potential. Curious - Listen and look forwardWe think differently and seek out opportunities for growth to exceed our stakeholders expectations. Courageous - Innovate with integrityWe challenge each other and do the right thing - even when its difficult - to deliver wins for our customers.Join our team and work in support of a technology platform that can transform how consumer goods are made bought sold and recycled around the globe. Digimarc is committed to the health and safety of our employees and their families. We are dedicated to diversity professional development and the success of our employees. For more information visit us at www.digimarc.com.Digimarc is seeking diverse applicants. We are an equal opportunity employer and consider qualified applicants for employment without regard to race gender age color religion disability veteran status sexual orientation gender identity or any other protected factor. We want the best people who share our values.This job posting is not designed to cover or contain a comprehensive listing of activities duties or responsibilities that are required of the employee for this job. Duties responsibilities and activities may change at any time with or without notice.Principals only. No recruiters please.Apply for this job

Remote Jobs in Myrtle Point, OR

Similar Job Searches

Stand out to leading employers.

Remote Jobs in Myrtle Point, OR

Healthcare Fraud Investigator at Integrity Advantage (Remote) HireAligned

Program Manager Remote Digimarc Corp

Similar Job Searches