• Manager , Fraud and Waste

    Humana (Columbus, OH)
    **Become a part of our caring community and help us put health first** The Manager , Fraud and Waste conducts investigations of allegations of fraudulent and ... abusive practices. The Manager , Fraud and Waste works...to coordinate investigations and supervises the activities of the Special Investigations Unit (SIU) to ensure accurate and timely… more
    Humana (12/19/24)
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  • Special Investigation Unit Program…

    CVS Health (Albany, NY)
    …regulatory reporting, coordinating interdepartmental program integrity initiatives, vendor oversight of fraud waste and abuse (FWA) activity, and identifying ... for compliance with state and federal regulations mandating the reporting of corporate fraud related activities and the preparation of the corporate Anti- Fraud more
    CVS Health (01/10/25)
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  • Principal, Compliance Operations - Special

    NJ Transit (Newark, NJ)
    …/ requested. + Develops reports and communication pieces on enhanced efforts to prevent fraud , waste and abuse in the DBE/SBE/DVOB aspects of NJ TRANSIT ... Principal, Compliance Operations - Special Programs and Projects Civil Rights & Diversity...implements quality assurance and quality controls (eg Peer review, Manager /Director signoff.) for key OBD processes applicable to DBE/SBE/DVOB… more
    NJ Transit (11/19/24)
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  • Assistant Pharmacy Manager - Long Term Care

    KPH Healthcare Services, Inc. (Appleton, WI)
    …random drug screening test **Required Training:** + HIPAAPrivacy Course + HIPAASecurity Course + Fraud , Waste , and Abuse Course + HIPPA Privacy CE Mastery Exam + ... supervision to store employees in the absence of Facility Manager . Assists Facility Manager in training and... Fraud , Waste , and Abuse CE Mastery Exam… more
    KPH Healthcare Services, Inc. (12/06/24)
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  • North Carolina - Regional Manager

    KPH Healthcare Services, Inc. (Gouverneur, NY)
    …drug screening test **Required Training:** + HIPPA Privacy Course + HIPPA Security Course + Fraud , Waste , and Abuse Course + MethGuard Course + HIPPA Privacy CE ... other duties as assigned **Qualifications** **Education:** + BS preferred ** Special Conditions of Employment:** + Drug test + Initial...Mastery Exam + HIPPA Security CE Mastery Exam + Fraud , Waste , and Abuse CE Mastery Exam… more
    KPH Healthcare Services, Inc. (12/17/24)
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  • Financial Crime Investigator I

    MyFlorida (Fort Lauderdale, FL)
    …the Bureau of Public Assistance Fraud is to aggressively identify and eliminate fraud , waste , and abuse to safeguard the integrity of taxpayer funded public ... EMPLOYMENT OPPORTUNITY DIVISION: CRIMINAL INVESTIGATIONS DIVISION BUREAU: PUBLIC ASSISTANCE FRAUD CITY: FORT LAUDERDALE COUNTY: BROWARD The Criminal Investigations… more
    MyFlorida (01/11/25)
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  • Senior Investigator, Pharmacy (Aetna SIU)

    CVS Health (Frankfort, KY)
    …of Pharmacy Fraud , Waste and Abuse. + Collaboration with Pharmacy Benefit Manager , providing meaningful evidence of Fraud , Waste and Abuse to support ... and affordable. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator (Pharmacy) to join our Special Investigations Unit. In… more
    CVS Health (01/11/25)
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  • Compliance Manager - Must Reside…

    Magellan Health Services (San Diego, CA)
    …Internal Audit and Special Investigations Unit (SIU) on compliance matters including fraud , waste , and abuse auditing and monitoring, as directed. + Ensures ... Serves as the compliance and privacy manager for assigned areas of the company or...program as assigned or, where applicable, security, HIPAA, and anti- fraud efforts within the assigned Care Center. + Assists… more
    Magellan Health Services (11/15/24)
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  • Program Manager

    NANA Regional Corporation (Morgantown, WV)
    …attention to detail + Maintains sensitivity to, and report on, instances of fraud , waste and abuse. + Demonstrated knowledge of project management processes ... Akima Facilities Operations is looking for a Program Manager to work in the Morgantown WV; Pittsburgh, PA OR Albany, OR location. Candidate will be responsible for… more
    NANA Regional Corporation (12/28/24)
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  • Operations Manager - Transportation

    Modivcare (Edison, NJ)
    …that adjustments are made, as necessary. + Train staff on how to identify and prevent fraud waste and abuse. + Assists with providing support to the office staff ... national origin, age, handicap or disability, or status as a Vietnam-era or special disabled veteran in accordance with federal law. If you need assistance, please… more
    Modivcare (12/24/24)
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  • Compliance Analyst

    Billings Clinic (Billings, MT)
    …and/or to prevent or reduce vulnerability to illegal, unethical or improper conduct, fraud , abuse and waste . Reports regularly to Compliance Director and ... and/or to prevent or reduce vulnerability to illegal, unethical or improper conduct, fraud , abuse and waste . Reports regularly to Compliance Director and… more
    Billings Clinic (12/03/24)
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  • Auditor (Performance)

    Department of State - Agency Wide (Washington, DC)
    …conventional procedures and practices Conducts analyses to detect the existence of fraud , waste , and/or mismanagement in the Department or USAGM operations. ... economy, efficiency and effectiveness of program and management operations, identifying instances of fraud , waste , and mismanagement. OR IN ADDITION to the above… more
    Department of State - Agency Wide (01/08/25)
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  • Clinical Provider Auditor II - Maryland Behavioral…

    Elevance Health (Hanover, MD)
    …of 4 years medical coding/auditing experience, including minimum of 1 year in fraud , waste abuse experience; or any combination of education and experience, ... and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an impact:**...trends and changes in laws/regulations. + Collaborates with the Special Investigation Unit and other internal areas on matters… more
    Elevance Health (01/08/25)
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  • Long Term Care Pharmacist

    KPH Healthcare Services, Inc. (Lancaster, PA)
    …the specific position **Required Training:** + HIPPA Privacy Course + HIPPA Security Course + Fraud , Waste , and Abuse Course + HIPPA Privacy CE Mastery Exam + ... Work on-call schedule, where applicable + Interacts with Facility Manager in the appropriate completion of hiring practices, performance...HIPPA Security CE Mastery Exam + Fraud , Waste , and Abuse CE Mastery Exam… more
    KPH Healthcare Services, Inc. (01/04/25)
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  • Pharmacist

    KPH Healthcare Services, Inc. (Lehighton, PA)
    …the specific position **Required Training:** + HIPPA Privacy Course + HIPPA Security Course + Fraud , Waste , and Abuse Course + HIPPA Privacy CE Mastery Exam + ... Work on-call schedule, where applicable + Interacts with Facility Manager in the appropriate completion of hiring practices, performance...HIPPA Security CE Mastery Exam + Fraud , Waste , and Abuse CE Mastery Exam… more
    KPH Healthcare Services, Inc. (12/14/24)
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  • Cook II (MAC)

    SUNY Morrisville (Morrisville, NY)
    …+ Responsible for appropriate use of facility supplies and equipment to minimize loss, waste , and fraud + Performs various kitchen maintenance tasks such as, but ... 9 2025 Job Description: COOK II REPORTS TO: Chef Manager | DEPARTMENT: Dining Services CLASSIFICATION: Hourly | GRADE:...use, material and equipment to avoid unnecessary expense and waste + Follows procedures for the proper storage of… more
    SUNY Morrisville (01/09/25)
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  • Cook I (MAC)

    SUNY Morrisville (Morrisville, NY)
    …+ Responsible for appropriate use of facility supplies and equipment to minimize loss, waste , and fraud + Performs various kitchen maintenance tasks such as, but ... 9 2025 Job Description: COOK I REPORTS TO: Chef Manager DEPARTMENT: Dining Services CLASSIFICATION: Hourly | GRADE: 12...use, material, and equipment to avoid unnecessary expense and waste + Follows procedures for the proper storage of… more
    SUNY Morrisville (01/09/25)
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  • Home Health LPN - Per Diem

    KPH Healthcare Services, Inc. (Hoffman Estates, IL)
    …the specific position **Required Training:** + HIPPA Privacy & Security Course + Fraud , Waste , and Abuse Course **Job Skills Required:** + Communicates ... care to clients as delegated by the RN Case Manager . **Responsibilities** **Job Duties:** + Provides professional nursing care...up to eight hours per day. Involves prolonged phone ** Special Conditions of Employment:** + Drug test + Initial… more
    KPH Healthcare Services, Inc. (12/15/24)
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  • Compliance Coordinator - Enterprise Risk - System…

    Bon Secours Mercy Health (OH)
    …maintenance of policies and procedures, education and communications. + Maintains awareness of fraud , waste and abuse laws and regulations and current industry ... Primary Function/General Purpose of Position** Under the direct supervision of the Manager , Compliance, this position contributes to the Bon Secours Mercy Health… more
    Bon Secours Mercy Health (01/10/25)
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  • Grants Management Specialist, Monitoring Officer

    Corporation for National and Community Service (IN)
    …within set deadlines. Makes recommendations for improvement when applicable. Refers suspected fraud , waste , and abuse to the Office of Inspector General. ... Ensures noncompliance is resolved. Liaises with regional staff (ie, Senior Portfolio Manager or Portfolio Manager ) to resolve noncompliance findings by… more
    Corporation for National and Community Service (01/10/25)
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