Responsible for conducting internal control audits and risk assessments to ensure compliance with applicable contract provisions and government regulations, identifying deficiencies or opportunities for improvement, issuing and monitoring Corrective Action Plans. Conduct investigations of internal policy violations and employee misconduct, and providing guidance to management on corrective or mitigating action. Provide education to business units on internal policies and compliance. Generate reports on compliance activities for executive management, board of directors, and external business partners.Update and maintain departmental policies, procedures, and training materials.

Investigated allegations of employee misconduct and policy violations, and drafted detailed reports of investigative actions and findings for referral to Human Resources and senior management. Made recommendations for corrective action supported by corporate policy and precedent. Reviewed employee Conflict of Interest disclosures and provided guidance to management on mitigation plans. Provided guidance to team members conducting fraud and abuse investigations. Maintained a working catalog of departmental policies and procedures and made recommendations for process improvements. Compiled monthly and quarterly reports of significant investigative activity and departmental metrics for the Board of Directors.

Provided supervision and guidance to a technical support team for onsite and remote employees.Managed workflow of ticketed incidents and outages.Assisted team manager with employee performance evaluations, staffing models, and annual budget.Maintained departmental procedures and contributed to divisional knowledge base.Analyzed incident data and collaborated with other support teams to identify root cause and mitigation.Graduate of BlueCross BlueShield SC Entry Level Training ProgramObtained CompTIA A+, Network +, and Security + certifications.

Conducted criminal and civil fraud and abuse investigations in the Medicare program.Audited medical equipment suppliers against program standards and identified program compliance violations.Drafted investigative/audit reports for referral to local, state, and federal authorities.Analyzed claims data to identify and recover overpayments made to providers.Planned and organized investigative operations.Drafted and maintained desk procedures.

Responded to calls for assistance and investigated street-level criminal activity.Trained new deputies and evaluated their readiness for solo duty.Created desk procedures to standardize operations in the Desk Sergeant role.Supervised Desk Sergeant staff and interviewed applicants for Deputy Sheriff.