- Elevance Health (Los Angeles, CA)
- **Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & Abuse** **Location:** This position will work a hybrid model (remote and office). The ... locations. **Hybrid Workplace Strategy:** 1-2 days in office per week The ** Clinical Fraud Investigator II** is responsible for identifying issues and/or… more
- CVS Health (Hartford, CT)
- …care more personal, convenient and affordable. **Position Summary** As a Senior Investigator you will conduct high level, complex investigations of known or ... suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive...lines of business + Researches and prepares cases for clinical and legal review + Documents all appropriate case… more
- Humana (Indianapolis, IN)
- …a part of our caring community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will ... oversee the monitoring and enforcement of the fraud , waste, and abuse (FWA) compliance program to prevent...areas + Adequately staff and manage the program integrity investigator (s) responsible for all FWA detection programs and activities… more
- CVS Health (Tallahassee, FL)
- …and affordable. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU). ... will manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + Conduct high level, complex… more
- Centene Corporation (Austin, TX)
- …fraudulent and erroneous practices. + Collaborate with investigators to identify abuse and fraud by utilizing clinical and coding expertise to analyze patterns ... on workplace flexibility. POSITION IS REMOTE **Please Note: This position REQUIRES Fraud , Waste and Abuse experience. Candidates that do not possess Fraud… more
- CVS Health (Columbus, OH)
- …care more personal, convenient and affordable. **Position Summary:** As a Senior Investigator you will conduct high level, complex investigations of known or ... suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive...lines of business - Researches and prepares cases for clinical and legal review - Documents all appropriate case… more
- State of Georgia (Fulton County, GA)
- …Job Alerts The Office of the Attorney General Georgia Department of Law Nurse Investigator - Medicaid Fraud Division *To move forward in the recruiting process ... Nurse Investigator Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/51086/other-jobs-matching/location-only) Hot...will serve within the Audits section of the Medicaid Fraud Division. Job Summary Under the direction of the… more
- CVS Health (Columbus, OH)
- …convenient and affordable. Kentucky Resident is preferred The SIU Investigator conducts complex investigations to effectively pursue the prevention, investigation ... and prosecution of healthcare fraud and abuse, to recover lost funds, and to...providers, claimants, etc. - Researches and prepares cases for clinical and legal review. - Documents all appropriate case… more
- Molina Healthcare (KY)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... records to document relevant findings of a post pay clinical review. This position manages documents and prioritizes case...of experience working in a FWA / SIU or Fraud investigations role for New Jersey/New York location +… more
- Fallon Health (Worcester, MA)
- …is a plus, such as Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), or other coding certifications or similar in the ... nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences,...Director of Internal Audit in their leadership of the Fraud , Waste and Abuse (FWA) program. The FWA Manager… more
- Vera Therapeutics (Brisbane, CA)
- Title: Clinical Trial Manager Location: Brisbane, CA About Us: Vera Therapeutics (Nasdaq: VERA), is a late-stage biotechnology company focused on developing ... Position Summary: We seek a highly skilled and motivated Clinical Trial Manager to join a fast-paced and collaborative...CRF completion guidelines, etc. * Attend and/or present at Investigator Meetings as needed. * May travel up to… more
- Bausch + Lomb (Rochester, NY)
- …of the Director, Clinical Research and the direction of the Principal Investigator (PI). While the PI is primarily responsible for the overall design, conduct, ... advancement of eye health in the future. **Position Objectives** A Senior Clinical Research Coordinator (Sr. CRC) is a specialized medical research professional… more
- Lilly (IN)
- …support our Immunology business unit. Do you have experience in early phase clinical trials? This role will have the exciting responsibility of supporting Lilly ... various legal matters related to: + Execution of currently running Phase 2b clinical trial within acquired subsidiary. + Communication plans for Phase 2b clinical… more
- Astellas Pharma (Northbrook, IL)
- …advisory boards and councils, data sharing and data licensing, investigator -initiated studies, regulatory and quality agreements; (ii) T&M, including supply ... support of Development, including agreements for collaborations, combination studies, clinical trials, assay development, companion diagnostics, expanded access, compassionate… more
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