- Gilead Sciences, Inc. (Miami, FL)
- …live or their economic status. **About the Role** The global pharmaceutical crime and healthcare fraud market is currently estimated at $400 billion annually. It ... lead and accelerate the development of the group's pharmaceutical crime and healthcare fraud program. The role will include both people leadership and individual… more
- Highmark Health (Columbus, OH)
- …+ Certified Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge ... **EXPERIENCE** **Required** + 5 years in the Health insurance industry and/or Healthcare fraud investigations + 1 year of leading projects of varying size and… more
- Umpqua Bank (Tigard, OR)
- Senior Fraud Investigator Corporate Risk Tigard, Oregon **Description** **About Us:** Umpqua Bank is headquartered in the Pacific Northwest with 5,000+ ... investigation analysis and findings. + Analyzes customer accounts during investigations for fraud . + Interacts with senior management concerning matters related… more
- Humana (Indianapolis, IN)
- **Become a part of our caring community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity ... Officer, who will oversee the monitoring and enforcement of the fraud , waste, and abuse (FWA) compliance program to prevent and detect potential FWA activities… more
- CVS Health (Springfield, IL)
- …make health care more personal, convenient and affordable. Position Summary: As a Senior Investigator you will conduct high level, complex investigations of ... known or suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive or high profile, those that are national in scope, complex… more
- Elevance Health (Columbus, OH)
- …send you a check, or ask you for payment as part of consideration for employment. ** Senior Investigator ** + Job Family: FRD > Investigation + Type: Full time + ... + IA, W DES MOINES + MA, WOBURN **Description** ** Senior Investigator ** **Schedule:** 1-2 days per week...investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate… more
- Elevance Health (Columbus, OH)
- …send you a check, or ask you for payment as part of consideration for employment. ** Senior Investigator ** + Job Family: FRD > Investigation + Type: Full time + ... + Maine, South Portland + New Jersey, Morristown **Description** Job Description ** Senior Investigator - Virginia Medicaid** **Schedule:** 1-2 days per week… more
- Elevance Health (Columbus, OH)
- …send you a check, or ask you for payment as part of consideration for employment. ** Investigator Senior ** + Job Family: FRD > Investigation + Type: Full time + ... + Washington + District of Columbia + Georgia **Description** ** Investigator Senior ** _This position will work a...investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate… more
- CVS Health (Tallahassee, FL)
- …Components: - Conducts high level, complex investigations of known or suspected acts of healthcare fraud and abuse. - Routinely handles cases that are sensitive ... multi-disciplinary provider groups, or cases involving multiple perpetrators or intricate healthcare fraud schemes. - Investigates to prevent payment of… more
- CVS Health (Columbus, OH)
- …+ Conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply ... and practices. + Conducts investigations of known or suspected acts of healthcare fraud and abuse + Communicates with federal, state, and local law enforcement… more
- CVS Health (Hartford, CT)
- …behavior to effectively pursue the prevention, investigation and prosecution of Fraud Waste and Abuse. - Collaboration with Pharmacy Benefit Manager, providing ... meaningful evidence of Fraud , Waste and Abuse to support Pharmacy Audit activities....Medical terminology. Advanced skills with Microsoft Excel. Experience in healthcare /pharmacy insurance claims investigation. Proficient in data analysis and… more
- Elevance Health (Columbus, OH)
- …for the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds ... you a check, or ask you for payment as part of consideration for employment. ** Investigator II** + Job Family: FRD > Investigation + Type: Full time + Date… more
- Elevance Health (West Des Moines, IA)
- …for the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds ... you a check, or ask you for payment as part of consideration for employment. ** Investigator II - Medicaid (Iowa)** + Job Family: FRD > Investigation + Type: Full… more
- DoorDash (San Francisco, CA)
- …(Canada, Mexico, Australia, and New Zealand). About the Role The Senior Workplace Investigations Business Partner ( Sr . Workplace Investigations BP) ... the consistent application of policies and procedures across the organization. The Sr . Workplace Investigations BP reports to the Senior Manager, Workplace… more
- MD Anderson Cancer Center (Houston, TX)
- …of alleged fraud , waste, and abuse activities as an auditor or fraud investigator . With preferred degree, five years of experience required. May substitute ... compliance investigations. JOB SPECIFIC COMPETENCIES General Compliance Activities The Investigator , Research Compliance, will be responsible for consistently managing… more