- New York State Civil Service (New York, NY)
- …auditors, detectives, data analysts, and legal support analysts, to conduct complex, long-term healthcare fraud and patient abuse and neglect investigations. ... No Agency Attorney General, Office of the Title Medical Analyst: Legal Nurse, Fraud /Patient Abuse (6413) Occupational Category Legal Salary Grade NS Bargaining… more
- Zelis (Boston, MA)
- …in prevention, detection, reporting, and monetary recovery related to financial fraud and healthcare fraud , waste, and abuse . What You'll Do + Perform ... it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare...to identify internal or external fraudulent activity, including potential Fraud , Waste, and Abuse (FWA), across all… more
- General Dynamics Information Technology (Fairfax, VA)
- …healthcare coding (eg, ICD-10, CPT, HCPCS) + Experience in program integrity and healthcare fraud , waste, and abuse activities, including edits, audits, ... a 50-person team supporting the TTP which was established in 2012 to reduce fraud , waste and abuse in healthcare data. We are GDIT. The people supporting and… more
- CVS Health (Richmond, VA)
- …you will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse . Routinely handles cases that are sensitive ... state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters. + Demonstrates high level of knowledge… more
- CVS Health (San Antonio, TX)
- …a team of investigators to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse , to recover lost funds, and to ... Leads the team in the planning and execution of investigations of acts of healthcare fraud and abuse by both members and providers. Provides direction and… more
- CVS Health (St. Paul, MN)
- …- Conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse , to recover lost funds, and ... plans and practices. - Conducts investigations of known or suspected acts of healthcare fraud and abuse . - Communicates with federal, state, and local law… more
- Molina Healthcare (Ann Arbor, MI)
- …The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position ... of experience working in a FWA / SIU or Fraud investigations + Thorough knowledge of PC based software...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- CVS Health (Columbus, OH)
- …communication skills + Advanced experience in Excel **Preferred Qualifications** + Experience in healthcare fraud , waste and abuse + Knowledge of Medicaid ... skills in SQL and Python who can transform complex healthcare data into actionable insights to support fraud , waste, and abuse (FWA) detection and Medicaid… more
- New York State Civil Service (Hauppauge, NY)
- …detectives, and analysts to identify and prosecute financial fraud in the healthcare industry and abuse and neglect of residents in healthcare ... HELP No Agency Attorney General, Office of the Title Attorney: Prosecute Medicaid Fraud /Nursing Home Abuse (3836) Occupational Category Legal Salary Grade NS… more
- Centene Corporation (Columbus, OH)
- …state of Ohio are highly preferred.** **Position Purpose:** Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, ... claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse . + Conduct investigations of potential waste,… more
- Idaho Division of Human Resources (Boise, ID)
- …or administrative hearings. + Knowledge of state and federal laws related to Medicaid, healthcare fraud , and abuse . + Candidates with certifications such as ... at least 5 years of investigative experience, preferably in law enforcement, healthcare fraud or financial crimes. Strong analytical; interviewing, and… more
- AmeriHealth Caritas (Columbia, SC)
- …+ An associate's degree, with a minimum of four years of experience working in healthcare fraud , waste, and abuse investigations and audits. + Experience and ... with all requirements related to Special Investigation Units and fraud , waste and abuse investigations. + Conducts...experience in the healthcare field working in fraud , waste, and abuse investigations and audits… more
- CVS Health (Topeka, KS)
- …this role, you will manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + ... Conduct high level, complex investigations of known or suspected acts of healthcare fraud , waste and abuse . + Conduct Investigations to prevent payment of… more
- Genentech (South San Francisco, CA)
- …role includes the following: + Providing advice, education, training and legal direction on, healthcare fraud and abuse laws, pricing, FDA labeling and ... **The Position** Genentech's Healthcare Law Group (HLG) seeks a Senior Corporate...regulations, the False Claims Act, and laws related to fraud and abuse in the life science/biotech/pharma… more
- LA Care Health Plan (Los Angeles, CA)
- Director, Compliance on Special Investigations Unit and Fraud , Waste and Abuse Job Category: Administrative, HR, Business Professionals Department: Special ... Job Summary The Director, Compliance on Special Investigations and Fraud , Waste and Abuse (FWA) is responsible...Experience Required: At least 7 years of experience in healthcare compliance, fraud investigations, law enforcement, or… more
- Regeneron Pharmaceuticals (Sleepy Hollow, NY)
- …product development, commercialization, and the legal and regulatory environment (including healthcare fraud and abuse , anti-kickback, and competition ... through commercialization, including advising on a broad range of healthcare regulatory matters, including regulatory labeling discussions, advertising and… more
- The Cigna Group (Philadelphia, PA)
- …of a reputable law firm with emphasis on anti-kickback, HIPAA, and other federal healthcare and fraud and abuse laws and regulations; experience with ... with the various state and federal laws impacting the healthcare supply chain. A minimum of 10 years of...and other external parties on matters relating to the healthcare supply chain + Assist business partners with developing… more
- Danaher Corporation (Brea, CA)
- …would be a plus if you also possess previous experience in: + Experience with healthcare regulation, including: fraud and abuse (eg, anti-kickback); FDA for ... we've been dedicated to advancing and optimizing the laboratory to move science and healthcare forward. Join a team where you can be heard, be supported, and always… more
- Danaher Corporation (Deer Park, IL)
- …diagnostic/IVD industry. + Experience in the medical device industry. + Experience with healthcare regulation, including fraud and abuse (eg, anti-kickback), ... FDA and CE/IVDR for medical devices, and data use and privacy (eg, HIPAA, GDPR). Key Competencies + Healthy ambition, defined as an innate drive to work hard, take ownership, and be a person of influence in the organization, producing great results and… more
- Humana (Oklahoma City, OK)
- …**Required Qualifications** + **Must be an Oklahoma resident** + 2+ years of healthcare fraud investigations and auditing experience + Knowledge of healthcare ... Oklahoma Medicaid Team. This team of Investigators conducts investigations into allegations of fraud , waste, and abuse involving providers who submit claims to… more