- Fairview Health Services (Minneapolis, MN)
- …legal and regulatory compliance Preferred Experience Knowledge of HIPAA privacy and security, Fraud , Waste and Abuse, REMS, DEA ARCOS Reporting, Hazardous ... Job Overview The Compliance and Licensing Program Manager is responsible for the development, implementation, and management of the pharmacy licensing program for… more
- UnitedHealth Group (Philadelphia, PA)
- …The Investigator is responsible for identification, investigation and prevention of healthcare fraud , waste and abuse. The Investigator will utilize claims data, ... the Company Investigate low to medium complex cases of fraud , waste and abuse Detect fraudulent activity...Maintain accurate, current and thorough case information in the Special Investigations Unit's (SIU's) case tracking system Collect and… more
- CVS Health (Harrisburg, PA)
- …Python who can transform complex healthcare data into actionable insights to support fraud , waste , and abuse (FWA) detection and Medicaid regulatory & compliance ... Design, develop, and maintain complex data analyses to support investigations of potential fraud , waste , and abuse in Medicaid claims and provider activity.… more
- Molina Healthcare (Grand Rapids, MI)
- …coordinating data extractions, gathering requirements, supporting payment integrity teams, primarily fraud , waste and abuse. Experience working on SQL, PowerBI, ... as requested on all things data related. Supports Operations and Implementations of special projects Responsible for analytics and reporting, acting as a Jr Project … more
- CVS Health (San Antonio, TX)
- …all with heart, each and every day. **Position Summary** Direct oversight of SIU and Fraud , Waste and Abuse activities related to TX Medicaid and CHIP programs. ... in federal and state audits. **Required Qualifications** 5+ years of managing healthcare fraud , waste and abuse investigations and audits. 3+ years of leadership… more
- Molina Healthcare (Louisville, KY)
- …and actions. + Works with leadership to maintain and revise policies and procedures, fraud , waste , and abuse plans, annual audit work plans, including department ... License, Certification, Association + Active and unrestricted Accredited Health Care Fraud Investigator (AHFI) designation or Certified Fraud Examiner (CFE)… more
- Molina Healthcare (Covington, KY)
- …delivery systems + Understanding of datamining and use of data analytics to detect fraud , waste , and abuse + Proven ability to research and interpret regulatory ... **JOB DESCRIPTION** **Job Summary** Under direct supervision of the Manager , SIU, the Team Lead is responsible to lead a small team of investigators and provide… more
- UPMC (Pittsburgh, PA)
- …to 4:30 pm This is a remote position. Under the direction of the manager , the Special Investigations Unit (SIU) Investigator is responsible for investigating ... assigned fraud , waste and abuse (FWA) cases, as...cases. This role includes supporting current SIU staff and manager with investigations and special projects. Responsibilities:… more
- Fairview Health Services (Minneapolis, MN)
- …and regulatory compliance **Preferred Experience** + Knowledge of HIPAA privacy and security, Fraud , Waste and Abuse, REMS, DEA ARCOS Reporting, Hazardous ... **Job Overview** The Compliance and Licensing Program Manager is responsible for the development, implementation, and management of the pharmacy licensing program… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …on the specific position **Required Training:** + HIPAA Privacy & Security Course + Fraud , Waste and Abuse Course **Job Skill Requirements:** + Business to ... As the primary point of contact for ProAct clients, the Account Manager is responsible for building relationships with new clients and coordinating internal… more
- Air Combat Command (Tyndall AFB, FL)
- …performance. Administers internal control system to preclude or minimize the potential for fraud , waste , and abuse. Arranges for equipment repairs and other ... at a level that meets current business trends and minimizes waste . Establishes financial goals, prepares budgets, analyzes financial results, maintains solid… more
- Parsons Corporation (Kingsport, TN)
- …possible. **Job Description:** Parsons is looking for an amazingly talented **Construction Quality Manager (** CQC System Manager ) to join our team! In this ... work. + Coordinate and oversee **testing and inspection activities** , including special inspections for structural steel, welding, concrete, and coatings. + Review… more
- SCI Shared Resources, LLC (Whittier, CA)
- …and provide detailed information for analysis as necessary. Establish safeguards against fraud , waste , and inefficiency. + **_Policies & procedures_** - Ensure ... to each area. **Leadership** + Provide leadership to all departments in the Manager of At-Need Operation areas of responsibility by setting the example, providing… more
- NANA Regional Corporation (Fort Gordon, GA)
- …attention to detail. + Maintains sensitivity to, and report on, instances of fraud , waste and abuse. + Demonstrated knowledge of project management processes ... **Responsibilities** + This position is responsible to the company President/General Manager for the direction, safe operation, compliance, quality delivery and… more
- Commander, Navy Installations (Groton, CT)
- …funds, merchandise, supplies, and equipment to preclude or minimize the potential for fraud , waste and abuse. Effectively supports the Navy's Equal Opportunity ... the facility to authorized patrons. Provide food service support for MWR Special Events, command functions and for official functions of visiting dignitaries when… more
- Point32Health (Canton, MA)
- …prevent future loss. This role will be responsible for conducting high-volume Pre-Payment Fraud Waste & Abuse ("FWA") investigations under the direction of the ... Investigation Unit ("SIU") responsible for leading complex provider investigations related to fraud , waste , and abuse, and developing action plans to address… more
- Aramco Services Company (Houston, TX)
- …conflict of interest, insider trading & anti-trust violations, procurement schemes and fraud . Involves in special inquiry investigations, that require a high ... be completed. + Conducts objective, thorough, and timely investigations into allegations of fraud , waste or abuse committed by employees or contractors against… more
- CVS Health (Columbus, OH)
- …Python who can transform complex healthcare data into actionable insights to support fraud , waste , and abuse (FWA) detection and Medicaid regulatory & compliance ... + Design, develop, and maintain complex data analyses to support investigations of potential fraud , waste , and abuse in Medicaid claims and provider activity. +… more
- Centene Corporation (Frankfort, KY)
- …as a subject matter expert for the Contractor's Program Integrity unit to reduce Fraud , Waste and Abuse of Medicaid services within Kentucky. Provides direction ... guidance to staff who investigate and remediate compliance and fraud , waste , and abuse related matters; while...an investigative workload of moderate to high complexity. Assists manager on monitoring team caseload and report on metrics.… more
- Army National Guard Units (Carson City, NV)
- …for filing IG complaints or IGARs. (4) Assists in the establishment and implements the Fraud , Waste and Abuse (FWA) program in accordance with United States Army ... guidelines set out in the Department of Defense (DoD) Hotline program for reporting Fraud , Waste and Abuse complaints. (5) As required, assists members of the… more
