About Us Don’t just find a job, find your WHY at a purpose-driven organization; discover a career at Virginia Premier. By blending quality benefits, affiliating with the world-renowned VCU Health System and offering career-advancing development programs, we allow our employees to focus on the meaningful work of improving and saving the lives of more than 200,000 people throughout the state of Virginia. At Virginia Premier, we are building an industry leading health care organization through dedicated teams that have heart, provide top-notch quality member services and embrace our mission of inspiring healthy living within the communities we serve. Our vision is to connect people to innovation, quality and affordable health care for all phases of life. If this sounds like you, read on! Overview POSITION OVERVIEW This position is responsible for managing multiple lines of business including multiple Medicaid and Medicare offerings. The responsible candidate will ensure federal and state contractual expectations are maintained for each line of business as it relates to claim payment accuracy guidelines. Additionally, the candidate will be responsible for auditing of the claim payment system, identifying overpayments, managing overpayment recoveries, and identifying process improvement opportunities. The identification and reduction of fraud, waste, and abuse will be the primary focus for team that this individual leads. Responsibilities POSITION DUTIES AND RESPONSIBILITIES
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