- CVS Health (Charleston, WV)
- …you will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse . Routinely handles cases that are sensitive ... state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters. + Demonstrates high level of knowledge… more
- CVS Health (Hartford, CT)
- …and oversee a team of investigators in our efforts to identify, prevent, and mitigate healthcare fraud , waste and abuse . This role involves not only ... within the team. **Required Qualifications** + Minimum of three years managing healthcare fraud , waste and abuse investigations and audits. + 7-10 years… more
- CVS Health (Columbus, OH)
- …conducts complex investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse , to recover lost funds, and ... state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters. - Demonstrates high level of knowledge… more
- CVS Health (Hartford, CT)
- …You will lead a team responsible for ensuring the quality and integrity of healthcare fraud and abuse investigations. This role involves overseeing the ... will lead a team responsible for ensuring the quality and integrity of healthcare fraud and abuse investigations. This role involves overseeing the training… more
- CVS Health (Baton Rouge, LA)
- …investigations to effectively pursue the prevention, detection, investigation and prosecution of healthcare fraud , waste, and abuse . Also reports suspected ... state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters. + Demonstrates high level of knowledge… more
- Molina Healthcare (Columbus, OH)
- …The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position ... of experience working in a FWA / SIU or Fraud investigations role for New Jersey/New York location +...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- Corewell Health (Grand Rapids, MI)
- …federal, state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters. Represents the SIU in various ... Investigations Unit (SIU). Responsible for developing and directing the fraud , waste and abuse (FWA) program processes and oversight and coordination of program… more
- CareFirst (Baltimore, MD)
- …+ Independently or as lead in part of an assigned team develop and conduct healthcare fraud , waste, and abuse investigations of all levels (low to ... which must be health care specific and includes independently conducting healthcare fraud , waste, and abuse investigations of all levels.… more
- CVS Health (Trenton, NJ)
- …this role, you will manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + ... Conduct high level, complex investigations of known or suspected acts of healthcare fraud , waste and abuse . + Conduct Investigations to prevent payment of… more
- Meta (Menlo Park, CA)
- …and climate regulations, hardware compliance, responsible supply chain management, and healthcare fraud & abuse . **Required Skills:** Associate ... and infrastructure hardware) 5. sustainability and climate regulations 6. and healthcare fraud & abuse . 7. Develop and communicate compliance policies,… more
- New York State Civil Service (New York, NY)
- …detectives, and analysts to identify and prosecute financial fraud in the healthcare industry and abuse and neglect of residents in healthcare ... Agency Attorney General, Office of the Title Attorney: Investigate, Prosecute Medicaid Fraud (3755) Occupational Category Legal Salary Grade NS Bargaining Unit M/C -… more
- Molina Healthcare (Columbus, OH)
- …and escalations are achieved. Coordinates with both the Associate Vice President of Fraud , Waste and Abuse (FWA) and Associate Vice President of Special ... and internal policies and procedures related to detecting, correcting, and preventing fraud , waste and abuse . Responsibilities may include data mining and… more
- Fallon Health (Worcester, MA)
- …+ Additional certification applicable to this work is a plus, such as Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), or ... position supports the Senior Director of Internal Audit in their leadership of the Fraud , Waste and Abuse (FWA) program. The FWA Manager will be responsiblefor… more
- Elevance Health (Atlanta, GA)
- **Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & Abuse ** **Location:** This position will work a hybrid model (remote and office). The ideal ... and/or entities that may pose potential risks associated with fraud and abuse . **How you will make...claims and medical records prior to payment. Researches new healthcare -related questions as necessary to aid in investigations. +… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- Position Purpose: The Manager - Fraud , Waste & Abuse (FWA) is responsible for day-to-day activities of the FWA Program while meeting operational and service ... WorkPlan, and related activities + Detect, investigate and report fraud , waste and abuse cases + Lead...5 years of experience in Medicare Advantage Plans or healthcare industry at large + Proven track record in… more
- AbbVie (Irvine, CA)
- …a broad spectrum of legal issues, with a particular focus on advertising and promotion, healthcare fraud and abuse , and related healthcare legislations. ... This position will work a hybrid work schedule from one of the following AbbVie locations: + Lake County, IL + Florham Park, NJ + Irvine, CA Responsibilities: + Serve as a key legal team member for the Botox Therapeutics and Eye Care business units,… more
- Amgen (Washington, DC)
- … laws and pharma association codes regulating interactions with the members of the healthcare community (eg, Fraud & Abuse Statute, Federal Healthcare ... tasks associated with business processes to Amgen's interactions with Healthcare Professionals, Healthcare Organizations, Patient Organizations and Educational… more
- New York State Civil Service (Albany, NY)
- …data analysts, nurses, and legal support analysts to conduct complex, long-term healthcare fraud investigations.The Medicaid program provides health coverage to ... General, Office of the Title Forensic Auditor: Entry-Level, Investigate Medicaid Fraud (6354) Occupational Category Financial, Accounting, Auditing Salary Grade NS… more
- New York State Civil Service (Syracuse, NY)
- …attorneys, auditors, detectives, data analysts, and nurses to conduct complex, long-term healthcare fraud investigations. The position is suitable for both ... Office of the Title New Legal Support Analyst Opportunity w/the Medicaid Fraud Control Unit in Syracuse (Ref #: MFCU_SYR_LSA_6359) Occupational Category Legal Salary… more
- New York State Civil Service (Albany, NY)
- …HELP No Agency Attorney General, Office of the Title Office Manager: Medicaid Fraud Control Unit, Albany (6357) Occupational Category No Preference Salary Grade NS ... NY Zip Code 12224 Duties Description Criminal Justice DivisionMedicaid Fraud Control Unit - AlbanyOffice ManagerReference No. MFCU_ALB_OM_6357Salary: $60,411To be… more