1596 Advanced Program Manager Data Governance jobs in Miami,FL

Bachelor's Degree (accredited), or in lieu of degree
High School Diploma or GED (accredited) and 4 years of relevant work experience.
5 years of relevant work experience with increased responsibility in construction, engineering, geology, operations management or heavy equipment (in addition to education requirement).
Must be open to possible relocation at the completion of the training program.

Investigator, Special Investigative Unit Coding-Miami Florida

Molina Healthcare

Miami, FL 33135

At least 2 years CPT coding experience in a surgical, hospital and/or clinic setting, or equivalent combination of relevant education and experience.
Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Professional Medical Auditor (CPMA), or American Academy of Professional Coders (AAPC) certified
Critical-thinking, problem-solving and analytical skills.
Ability to prioritize and manage multiple tasks.
Ability to work in a team setting.
Strong verbal/written communication skills, and presentation skills.
Microsoft Office suite (including Excel), and applicable software program(s) proficiency.
In some states, 5 years of experience working in a fraud, waste and abuse (FWA)/special investigations unit (SIU)/fraud investigations role may be required (dependent on state/contractual requirements).
Knowledge of investigative and law enforcement procedures with emphasis on fraud investigations.
Knowledge of Managed Care and the Medicaid, Medicare, and Marketplace programs.
Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems.
Ability to research and interpret regulatory requirements.