- Humana (Nashville, TN)
- …a part of our caring community and help us put health first** The Manager , Fraud and Waste Investigator: Nurse Audit/Review performs clinical ... of objectives and determines approach, resources, schedules and goals. The Manager , Fraud and Waste Investigator: Nurse Audit/Review validates and interprets… more
- CVS Health (Nashville, TN)
- …in federal and state audits. **Required Qualifications** + 2 to 5 years of managing healthcare fraud , waste and abuse investigations and audits. + 3 to 5 ... Brief Overview** Oversees corporate activities related to the prevention, investigation , and prosecution of health care fraud ...Leads a team in the planning and execution of investigations of acts of healthcare fraud and… more
- CVS Health (Nashville, TN)
- …large healthcare datasets. + Design, develop, and maintain complex data analyses to support investigations of potential fraud , waste , and abuse in Medicaid ... Python who can transform complex healthcare data into actionable insights to support fraud , waste , and abuse (FWA) detection and Medicaid regulatory & compliance… more
- Elevance Health (Nashville, TN)
- …of 4 years medical coding/auditing experience, including minimum of 1 year in fraud , waste abuse experience; or any combination of education and experience, ... and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an impact:**...new healthcare related questions as necessary to aid in investigations and stays abreast of current medical coding and… more
- Covenant Health Inc. (Knoxville, TN)
- …organization's management and staff and may participate in requested investigations . Maintains all organizational and professional ethical standards. Works ... Performs other duties as needed. Reports to the Revenue Integrity Manager . Recruiter: Suzie McGuinn || ###@covhlth.com Responsibilities Integrity + Identifies and… more