- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- Position Purpose: The Analyst - Fraud , Waste & Abuse (FWA) provides leadership in in the investigation of potential FWA cases; its main goal is aimed at ... detection and prevention of fraud , waste , and abuse . Key Responsibilities: + Conduct in-depth investigations of potential FWA cases using monitoring, audits,… more
- University of Rochester (Rochester, NY)
- … II conducts investigations, risk assessments, and regulatory monitoring to prevent and detect fraud , waste , and abuse , specifically addressing the DRA, NY ... reputational risk. **There are two pathways for the Compliance Analyst II (1: Compliance Billing, Coding, and Education ...with Medicare, Medicaid, and third-party payer billing regulations, and fraud , waste , and abuse prevention.… more
- General Dynamics Information Technology (Riverdale, MD)
- …the classified and unclassified systems of a major Intelligence Community Agency for fraud , waste , and abuse , to include inappropriate content, illegal ... **Job Description:** Own your career as a Cyber Security Analyst at GDIT. Here, you'll have the opportunity to...logs to determine events of interest. + Monitor for fraud , waste and abuse , including… more
- City of New York (New York, NY)
- …fluency, and critical thinking are vital to uncovering waste , fraud , and abuse . As a Data Analyst , you will manage and analyze large, disparate data sets ... DOI is seeking a highly skilled and motivated data analyst to join its Data Analytics Unit (DAU), which...enhance practices for identifying patterns and trends related to fraud , waste and abuse . -… more
- Option Care Health (Bannockburn, IL)
- …preferably with compliance requirements related to billing and coding, privacy and security, and fraud , waste and abuse , including but not limited to HIPAA, ... key risk areas such as regulatory changes, billing and coding, privacy and security, and fraud and abuse . + Perform data analysis and review of documentation to… more
- CVS Health (Hartford, CT)
- …Analyst ** within the Special Investigations Unit (SIU) plays a key role in supporting fraud , waste , and abuse investigations by managing and responding to ... and documentation across multiple lines of business and jurisdictions. The analyst collaborates closely with investigative teams, legal, compliance, and operational… more
- City of New York (New York, NY)
- …identify risks and opportunities to improve services through a coordinated structure that prevents fraud , waste , and abuse and fosters compliance with legal ... agencies in assessing their operational, financial and compliance risks, addressing waste and mismanagement, and improving the effectiveness of City operations.… more
- UPMC (Pittsburgh, PA)
- …with appropriate Health Plan departments including Quality Assurance, Medicare, and the Fraud , Waste team to facilitate the resolution of coding issues, ... either HCC coding, reviews or education, DRG experience, Clinical Documentation Improvement, Fraud & Abuse , Chart Auditing, or Quality Review experience… more
- MTA (New York, NY)
- …+ Reviews agency processes, procedures, and controls designed to manage and mitigate risk, fraud , waste , and abuse of agency resources. + Works within ... Senior Auditor/ Analyst Job ID: 12882 Business Unit: MTA Inspector...Date Posted: Sep 5, 2025 Description Job Title: Senior Auditor/ Analyst Annual Salary: $89,000 Open & Closing Dates: Open… more
- Air National Guard Units (Springfield, OH)
- …unique to the customer. Manages and executes internal control procedures to protect against fraud , waste , and abuse . Performs other duties as assigned. *The ... 5 EXCEPTED SERVICE POSITION. This National Guard position is for a FINANCIAL MANAGEMENT ANALYST , Position Description Number T5636P01 and is part of the OH 178 Wing,… more
- Air National Guard Units (Portland, OR)
- …unique to the customer. Manages and executes internal control procedures to protect against fraud , waste , and abuse . (10%) 7. Performs other duties as ... Summary This National Guard position is for a FINANCIAL MANAGEMENT ANALYST , Position Description Number D2514P01 / D2513P01 and is part of the Oregon Air National… more
- Prime Therapeutics (Pierre, SD)
- … is responsible for recovering inappropriate pharmacy payments related billing errors and fraud , waste and abuse (FWA) through various mechanisms, including ... our passion and drives every decision we make. **Job Posting Title** Recovery & Resolution Analyst - Remote **Job Description** The Recovery & Resolution Analyst… more
- MTA (New York, NY)
- …+ Reviews agency processes, procedures, and controls designed to manage and mitigate risk, fraud , waste , and abuse of agency resources. + Identifies issues ... Principal Auditor/ Analyst Job ID: 12883 Business Unit: MTA Inspector...Date Posted: Sep 5, 2025 Description Job Title: Principal Auditor/ Analyst Annual Salary: $97,500 Open & Closing Dates: Open… more
- New York State Civil Service (New York, NY)
- …correct.* Reviews agency processes, procedures, and controls designed to manage and mitigate risk, fraud , waste , and abuse of agency resources.* Works within ... NY HELP No Agency MTA Inspector General, Office of Title Senior Auditor/ Analyst Occupational Category Other Professional Careers Salary Grade NS Bargaining Unit None… more
- Centene Corporation (Tallahassee, FL)
- …techniques & tools to explore financial performance trends and/or reconciling financial data preferred. ** Fraud , Waste & Abuse :** Experience in fraud / ... waste / abuse identification and investigation, provider billing, or clinical coding preferred; Experience with data mining, machine learning, artificial intelligence, or statistical modeling preferred **Risk Adjustment:** Experience in risk adjustment,… more
- New York State Civil Service (New York, NY)
- …Reviews agency processes, procedures, and controls designed to manage and mitigate risk, fraud , waste , and abuse of agency resources.* Identifies issues ... HELP No Agency MTA Inspector General, Office of Title Principal Auditor/ Analyst Occupational Category Other Professional Careers Salary Grade NS Bargaining Unit… more
- Insight Global (Eden Prairie, MN)
- …retail like experience from a Payment Integrity standpoint helping reimagine how we identify healthcare fraud , waste and abuse , and how we make some of these ... will be supporting E&I USP Data & Analytics strategy around fraud transformation, improving operational efficiencies, affordability gaps etc., and will also… more
- CVS Health (Harrisburg, PA)
- …claims billed and educating pharmacies on the findings. You will also analyze claims for fraud , waste , and abuse trends and report your findings to the ... corporate office. To be successful in this role, you must have the ability to travel overnight approximately 75 percent of the time and able to maintain a corporate credit card. Overnight travel is required, ability to travel via car or air, transport a laptop… more
- CVS Health (AZ)
- …of the Lead Director, Service Operations, this position will focus on utilization, quality and fraud waste and abuse review for individual cases for members ... of suspected healthcare fraud cases Completion of Fraud waste and abuse reviews...Phoenix, Arizona area resident + National Board Certified Behavior Analyst -Doctoral (BCBA-D) and unencumbered license by the Arizona Board… more
- City of New York (New York, NY)
- …and compliance operations in support of the agency's mission to detect and deter fraud , waste and abuse . Allocate technological resources to provide for ... NOTE CANDIDATES MUST BE PERMANENT IN THE ADMINISTRATIVE STAFF ANALYST CIVIL SERVICE TITLE THE CORRECT SALARY RANGE FOR...It also manages the process by which all undercare fraud referrals are identified, triaged and assigned to the… more