- CVS Health (Providence, RI)
- …deliver solutions to make health care more personal, convenient and affordable. The Special Investigations Unit is seeking a Manager to lead our team of ... Certified Professional Coders (CPC). The Manager is responsible for overseeing and managing coding reviews for fraud detection, investigation , and prevention… more
- Humana (Providence, RI)
- …enforcement authorities to coordinate investigations and supervises the activities of the Special Investigations Unit (SIU) to ensure accurate and timely ... caring community and help us put health first** The Manager , Fraud and Waste conducts investigations of...field or equivalent. 7+ years of related compliance and/or special investigation experience in managed care or… more
- Veterans Affairs, Veterans Health Administration (Brockton, MA)
- …but are not limited to: Incumbent works under the direction of the Nurse Manager . Incumbent is accountable for the delivery of care to patients with a variety ... Permanent Change of Station (PCS): Not Authorized Notifications: This is a Bargaining Unit Position This position is in the Excepted Service Current and former… more
- Veterans Affairs, Veterans Health Administration (Providence, RI)
- Summary This RN - Care Manager position is located in the Office of Community Care Service at the Providence Location. This position is full-time at 40 hours per ... Permanent Change of Station (PCS): Not Authorized Notifications: This is a Bargaining Unit Position This position is in the Excepted Service Current and former… more
- Elevance Health (Smithfield, RI)
- …questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other internal areas on matters of ... analysis and clinical evaluation of the collected data. + Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance… more
- Travelers Insurance Company (West Bridgewater, MA)
- …as Social Security, Workers Compensation or others relevant to the jurisdiction. Consults with Unit Manager on use of Claim Coverage Counsel. + Investigation ... nurse consultants, and fire or fraud investigators and to other experts. Requests through Unit Manager and coordinate the results of their efforts and findings.… more
- State of Massachusetts (Brockton, MA)
- …The Area Director is responsible for tracking all DDS and DPPC investigations , developing Action Plans to respond to investigatory findings, and ensuring follow- ... up on required actions. As the Senior Departmental Manager at the local level, the Area Director must...press and media, state legislators and other political figures, special education directors and other School Department officials, senior… more
- CDM Smith (Pawtucket, RI)
- **38747BR** **Requisition ID:** 38747BR **Business Unit :** TSU **Job Description:** At CDM Smith, we are committed to tackling the complex challenges facing our ... white papers and technical design documentation of new or special case designs, studies, etc.. Collaborates with sales staff...Smith Placement Agreement from the CDM Smith Recruitment Center Manager to receive payment for your placement. Verbal or… more
- CDM Smith (Providence, RI)
- **38777BR** **Requisition ID:** 38777BR **Business Unit :** TSU **Job Description:** We offer hybrid work options and are open to candidates who would like to work in ... white papers and technical design documentation of new or special case designs, studies, etc. -Submits technical papers and...Smith Placement Agreement from the CDM Smith Recruitment Center Manager to receive payment for your placement. Verbal or… more
- Veterans Affairs, Veterans Health Administration (Brockton, MA)
- …may be required to serve a probationary period. Subject to background/security investigation . Selected applicants will be required to complete an online onboarding ... the accrediting body and not to specific job duties that might require special skills. Currently, APA accredits doctoral programs in the specialty areas of clinical… more