Program Integrity Manager and Special Investigations Unit Staffing Sample Clauses

Program Integrity Manager and Special Investigations Unit Staffing. Shall ensure oversight of the Contractor’s SIU activity. The Contractor shall ensure that the qualifications of the Program Integrity Manager are equal to those of the Agency Program Integrity Director. The Program Integrity Manager will serve as the liaison between the Contractor and State agencies, law enforcement, and federal agencies. The Program Integrity Manager shall be informed of current trends in Fraud, waste, and Xxxxx as well as mechanisms to detect such activity. The Program Integrity Manager shall be located in the Iowa offices. The position shall be dedicated at least 100% of the time to the oversight and management of the Program integrity efforts required under the Contract. The Program Integrity Manager shall have open and immediate access to all Claims, Claims processing data and any other electronic or paper information sufficient to meet the requirements of the Agency. The duties shall include, but not be limited to: (i) oversight of the Program integrity function under the Contract; (ii) liaison with the Iowa Medicaid in all matters regarding Program integrity; (iii) development and operations of a Fraud control program within the Contractor Claims payment system; (iv) liaison with Iowa’s MFCU and/or the Office of the Attorney General; (v) assure coordination of efforts with the Agency and other agencies with regards to Program integrity issues.
Sample 1
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Related to Program Integrity Manager and Special Investigations Unit Staffing

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