- CVS Health (Richmond, VA)
- …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 (Richmond, VA)
- …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
- Elevance Health (Richmond, VA)
- …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
- Elevance Health (Richmond, VA)
- …coding and billing issues, trends and changes in laws/regulations. + Collaborates with the Special Investigation Unit and other internal areas on matters of ... and risk avoidance based on the outcome of the investigation . + Trains new associates. + Develops, designs and...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Travelers Insurance Company (Richmond, VA)
- …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
- Federal Reserve Bank (Richmond, VA)
- …The Supervision, Regulation & Credit Department (Credit Risk Management and Reserves Unit ) is hiring a Collateral Analyst to plan and conduct assignments involving ... VA and will report to the Regulatory Risk Management Manager . **What You Will Do:** + Perform risk surveillance...the Reserve Bank premises. + Perform additional duties and special analytical studies as assigned. **Qualifications:** + 1 to… more
- CDM Smith (Richmond, VA)
- **37154BR** **Requisition ID:** 37154BR **Business Unit :** TSU **Job Description:** **This position will be based out of our closest CDM Smith office in the ... 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