Medical Provider Performance Executive

This position is responsible for conducting objective, fair, thorough, unbiased and timely investigations of healthcare providers for fraud, waste and abuse committed against Allianz group or its Payers by members, providers, or other entities whist monitoring best of relationships with all parties.

The position requires ingenuity and creativity to obtain case information not readily available, along with the ability to work independently with minimum supervision. Good organizational skills are needed to manage a high volume of assigned cases as well as the regular exercise of independent judgment and initiative to investigate allegations.

The investigator must have the analytical ability necessary to review, interpret and evaluate relevant information essential in resolving sensitive and complex investigations.

Responsabilities

• Fraud Abuse and Waste detections and prev...