Dental Investigator - State of North Carolina - Redmond, WA

Permanent Dental Receptionist / Front Desk Job

Redmond, WA

Job Description

Description of Work

This is a temporary position and there are no leave or retirement benefits offered with this position. Temporary employees who work an annual average of 30 or more hours per week may be eligible for health insurance coverage under the High Deductible Health Plan (HDHP). For more information on health benefits offered visit www.shpnc.org.

NOTE: If you are a current NC State Government employee, you will be considered for a temporary assignment. However, Temporary Solutions cannot accommodate dual employment.

This position has been reposted. Previous applicants must reapply to be considered. This temporary position is located in Raleigh, NC - Wake County.

Telework Availability:

We trust our employees to be self-motivated and successful in hybrid/remote roles; NC Department of Health and Human Services (DHHS) offers work from home options and variable work schedule flexibility for this position.

The Division of Health Benefits (DHB) requires temporary workers with an approved hybrid telework schedule to work onsite at their assigned duty station at least 4 working days per month. More information on this arrangement may be obtained at the time of the interview.

Hourly Rate: $28.00 to $32.00

(Hourly Rates are based on education, experience, equity, and budget)

Position Overview:

This is a temporary position within North Carolina Department of Health and Human Services (DHHS), Division of Health Benefits (DHB), NC Medicaid, Office of Compliance and Program Integrity (OCPI). OCPI is responsible for the detection and prevention of fraud, waste and abuse (FWA) in the delivery and cost of provider services and ensuring providers and managed care entities are in compliance with Medicaid rules and regulations. Functions and responsibilities for OCPI include compliance oversight of Medicaid health plans and contracted state vendors who conduct investigations of Medicaid FWA.

Job Specific Responsibilities:

Monitor dental provider compliance and contracted state vendors program integrity accountability to prevent fraud, waste and abuse (FWA).
Conduct dental fraud, waste & abuse (FWA) investigations
Ensure compliance with contracts through quality assurance reviews and monthly reporting.
Provide compliance oversight and quality control of vendor FWA dental investigations
Conduct investigations via analyzing documents and evidence, interviewing witnesses and summarizing findings in written reports.
Perform other duties as assigned.

Knowledge, Skills and Abilities / Competencies

To receive credit for all your work history and credentials, you must list the information on the application form. Any information listed under the text resume section or on an attachment will not be considered for qualifying credit. Qualified applicants must document on the application that they possess all the following:

Licensed to practice as a dental hygienist in North Carolina
Excellent verbal and written communication skills
Ability to interpret and apply rules, regulations, standards and policies regarding dental providers
Excellent time management and organizational skills
Proven ability to research and analyze data and information
Ability to establish and maintain effective working relationships with the public and department staff
Ability to work independently with minimum supervision

Management Preferences:

Program Integrity and/or investigations experience
Experience working in a federally funded healthcare program

Minimum Education and Experience Requirements

Some state job postings say you can qualify by an “equivalent combination of education and experience.” If that language appears below, then you may qualify through EITHER years of education OR years of directly related experience, OR a combination of both. See oshr.nc.gov/experience-guide for details.

Bachelor’s degree in a discipline relative to the program area from an appropriately accredited institution and four years of related experience; or an equivalent combination of education and experience.

Supplemental and Contact Information

The North Carolina Department of Health and Human Services (NCDHHS) works closely with beneficiaries, health care professionals, community leaders and advocacy groups; local, state, and federal entities; and other community partners vested to improve the health and safety of all North Carolinians by providing essential human services. NCDHHS is one of the largest, most complex agencies in the state, with about 17,000 employees.

The Division of Health Benefits (DHB) within NCDHHS is committed to advancing innovative solutions that improve health, promote well-being and foster independence for all North Carolinians. DHB manages and oversees North Carolina Medicaid, NC Medicaid Managed Care and other programs that provide access to services and support for parents, children, seniors, people with intellectual / developmental disabilities, and behavioral health, substance use and traumatic brain injury disorders. With a budget of over $21 billion in state and federal funds per fiscal year, DHB ensures that more than 96,000 enrolled providers are reimbursed for delivering covered services to 2.9 million beneficiaries.

Realizing the strength of DHB lies in its employees, DHB remains dedicated in its efforts to create and maintain a diverse, equitable and inclusive workplace environment. Pre-Employment criminal background checks are required for all positions with the Division of Health Benefits (DHB).

Due to the volume of applications received, we are unable to provide information regarding the status of your application over the phone. To check the status of your application, please log in to your account. For technical issues with your application, please call the NeoGov Help Line at 855-524-5627.

NOTE: For temporary, contract or other supplemental staffing appointments: There are no paid leave, retirement or other benefits associated with these appointment types.For permanent and time-limited appointments: Eligible employees have benefits that include employee health insurance options, standard and supplemental retirement plans, NC Flex (a variety of high-quality, low-cost benefits on a pre-tax basis), and paid vacation, sick, and community service leave, to name a few. Paid parental leave is available for eligible employees. Some benefits require 30 + hours work/week for participation.

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