Robert Flood

Compliance Siu Manager @AIDS Healthcare Foundation

Miami, TX, US

The Compliance/Special Investigative Unit (SIU) Manager works with the Compliance Officer to oversee the Special Investigative Unit for the investigation of possible fraud, abuse, and overpayment and ensures mandatory reporting as required by this contract, state and federal law. Additionally, the SIU Manager assists in maintaining an effective compliance program for all of AHF MCO’s managed care lines of business in order to promote ethical practices and a commitment to compliance with applicable federal, state, and local laws, rules, regulations and internal policies and procedures and to prevent and detect fraud, waste and abuse. The Compliance/SIU Manager’s responsibilities include data mining and data analysis, conducting and summarizing compliance audits, developing audit tools based on regulatory and contract requirements, conducting and documenting investigations of any potential fraud, waste, abuse and overpayment allegations and/or issues, assisting in responding to external audits, maintaining a schedule of active Corrective Action Plans and assisting the Compliance Officer in preparation and follow-up activities for the Managed Care Compliance Committee and the Special Investigative Unit Committee. Additionally the Compliance/SIU Manager is responsible for maintaining a current schedule of all required managed care reports for AHF MCO, and for tracking and notifying managers regarding report deadlines.

Boston University

MCJ, Criminal Justice

Fordham University

BA, Political Science

NYPD Police Academy

Law Enforcement