- CVS Health (Annapolis, MD)
- …to power the growth of tomorrow's business! As a Sr. Manager, Digital Product for Fraud , Waste & Abuse (FWA), you will oversee the maintenance and ... years' experience developing best practice documentation **Preferred Qualifications** + Knowledge of fraud , waste and abuse identification and management +… more
- CVS Health (Annapolis, MD)
- …experience + Advanced experience in Excel **Preferred Qualifications** + Experience in healthcare fraud , waste and abuse + Knowledge of healthcare ... **Required Qualifications** + 7+ years relevant work experience in the healthcare industry + Solid understanding and experience interpreting medical claim data… more
- CareFirst (Baltimore, MD)
- …or as lead in part of an assigned team develop and conduct healthcare fraud , waste , and abuse investigations of all levels (low to complex). Develop ... health care specific and includes independently conducting healthcare fraud , waste , and abuse investigations of all levels. **Licenses/Certifications**… more
- Maryland Department of Transportation (Anne Arundel County, MD)
- …functions. These functions typically include planning, conducting, and finalizing investigations of fraud , waste , and abuse in a timely, effective ... to the following: + Receives and logs allegations about fraud , waste , and abuse and...We offer more than just a paycheck We offer healthcare , dental, long term disability, flexible work schedules, and… more
- Elevance Health (Hanover, MD)
- …errors. Works with health plan leaders, oversees the monitoring and enforcement of the fraud , waste , and abuse compliance program to prevent and detect ... potential fraud , waste , and abuse activities pursuant to state...Requires a BA/BS in business, engineering, nursing, finance, or healthcare administration and minimum of 5 years related work… more
- SMX (Washington, DC)
- …and develops mitigation strategies + ** Fraud Investigation:** Conducts investigations into suspected fraud , waste , and abuse + ** Fraud Awareness and ... Analyzes costs to identify opportunities for savings and efficiencies ** Fraud Prevention and Detection** + ** Fraud Risk...the DoD to highly assured and compliant solutions for healthcare , we understand that digital transformation is key to… more
- Elevance Health (Hanover, MD)
- …and minimum of 4 years medical coding/auditing experience, including minimum of 1 year in fraud , waste abuse experience; or any combination of education and ... and/or entities that may pose potential risk associated with fraud and abuse . **How you will make...next step in the claims lifecycle. + Researches new healthcare related questions as necessary to aid in investigations… more
- Humana (Annapolis, MD)
- …to better case management outcomes, improved utilization management, prevention or identification of fraud waste and abuse , and trend data. **5%:** Other ... benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also...our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions… more
- Humana (Annapolis, MD)
- …regulatory and operational issues. + Provide guidance related to the application of fraud , waste , and abuse laws, including the Anti-Kickback Statute, ... benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also...our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions… more
- Office of Personnel Management (Washington, DC)
- …warehouse. Develops detailed requirements for new or revised computer applications to identify fraud , waste , abuse , and improper payments. Assesses the ... the public or private sectors) performing all the following tasks: Reviewing healthcare insurance claim to ensure accurate data processing and compliance with… more