| Focus Area |
FWA – General Program Integrity (broad fraud, waste, abuse oversight), Provider Fraud & Abuse, Member Eligibility & Fraud, Claims & Billing Integrity, Pharmacy & Prescription Fraud, Data Analytics & Surveillance, Legal / Investigation / Prosecution Support, Other
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| Certifications (CFE, PMP, etc.) |
CFE
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| Programs Worked With (Medicaid, Medicare, CHIP, MCO, etc.) |
Medicaid Fee-for-Service (FFS), Medicaid Managed Care Organizations (MCOs), Children’s Health Insurance Program (CHIP), Medicaid Waivers (1115, 1915(c), 1915(b)), Long-Term Services & Supports (LTSS) / HCBS, Behavioral Health Integration, Dual Eligible & Medicare Coordination
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| Focus Area |
Fraud, Waste & Abuse (FWA), Provider Enrollment & Screening, Member Fraud & Eligibility Oversight, Data Analytics & Surveillance, Audits & Compliance Monitoring, Legal & Prosecution Support, Policy Development & Guidance, Other
|
Corporate Partner