- CVS Health (Cary, NC)
- … Unit is seeking a Sr. Manager to lead our new ASO investigations team. The Healthcare Fraud Senior Manager is responsible for overseeing ... and external stakeholders and ensuring compliance with regulatory requirements. The Senior Manager develops strategies to mitigate fraud risks, analyzes complex… more
- Elevance Health (Cary, NC)
- …for identifying issues and/or entities that may pose potential risks associated with fraud and abuse. **How you will make an impact:** + Examines claims ... relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. + Reviews and...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses… more
- Elevance Health (Durham, NC)
- …the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent ... claims . **How you will make an impact:** + Claim...+ Responsible for identifying and developing enterprise-wide specific healthcare investigations that may impact more than one company health… more