- Novo Nordisk Inc. (Plainsboro, NJ)
- …ready to realize your potential? The Position Provide legal counsel to global healthcare company on relevant issues involving application of US law, regulations, and ... on interactions with health care providers, patients, and payors in compliance with fraud and abuse laws such as the US Anti-Kickback Statute and industry codes,… more
- Eisai, Inc (Nutley, NJ)
- At Eisai, satisfying unmet medical needs and increasing the benefits healthcare provides to patients, their families, and caregivers is Eisai's human health care ... in good standing of a state bar. Strong knowledge of FDA regulatory and fraud and abuse laws and/or pharmaceutical government price reporting laws. Ability to learn… more
- Baxter International, Inc. (Memphis, TN)
- …For over 85 years, we have pioneered significant medical innovations that transform healthcare . Together, we create a place where we are happy, successful and ... solutions every day. As our primary connection to the healthcare professionals who rely on our products to save...of your request along with your contact information. Recruitment Fraud Notice Baxter has discovered incidents of employment scams,… more
- CVS Health (Hartford, CT)
- …each and every day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU). ... you will manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + Conduct high level,… more
- New York State Civil Service (Albany, NY)
- …detectives, data analysts, and legal support analysts, to conduct complex, long-term healthcare fraud and patient abuse and neglect investigations. The Medicaid ... Agency Attorney General, Office of the Title Legal Nurse/Medical Analyst: Medicaid Fraud Control Unit (6393) Occupational Category Legal Salary Grade NS Bargaining… more
- New York State Civil Service (New York, NY)
- …data analysts, and legal support analysts to conduct complex, long-term healthcare fraud investigations. The Medicaid program provides health coverage ... No Agency Attorney General, Office of the Title Legal Nurse/Medical Analyst:Medicaid Fraud Control Unit (6388) Occupational Category Legal Salary Grade NS Bargaining… more
- Elevance Health (Norfolk, VA)
- …+ Coding Certificate or Registered Nurse preferred. + Law Enforcement investigation of healthcare fraud experience. Please be advised that Elevance Health only ... **Clinical Fraud Investigator Senior** **Location:** _Hybrid1:_ This role requires...and medical records prior to payment. + Researches new healthcare related questions as necessary to aid in investigations.… more
- State of Georgia (Fulton County, GA)
- …or more items below: + Attorneys with civil litigation experience, with an emphasis on healthcare or fraud matters. + Demonstrated ability to work in a team is ... Assistant Attorney General- Medicaid Fraud Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/67792/other-jobs-matching/location-only) Hot… more
- CVS Health (Annapolis, MD)
- …- Conducts investigations to effectively pursue the prevention, investigation, and prosecution of healthcare fraud and abuse, to recover lost funds, and to ... 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 (Carson City, NV)
- …conducts complex investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to ... and local law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters. - Demonstrates high level of knowledge and… more
- MyFlorida (Tallahassee, FL)
- …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator; Certified ... is to ensure fewer budgeted dollars are lost to fraud , abuse, and waste. The Bureau of Medicaid Program...(MPI) does this specifically through audits and investigations of healthcare providers, including managed care plans, suspected of engaging… more
- CareFirst (Baltimore, MD)
- …+ Independently or as lead in part of an assigned team develop and conduct healthcare fraud , waste, and abuse investigations of all levels (low to complex). ... 3 of which must be health care specific and includes independently conducting healthcare fraud , waste, and abuse investigations of all levels. **Knowledge,… more
- Highmark Health (Dover, DE)
- …3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations **Preferred** + 1 year in Financial Analysis ... Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider… more
- New York State Civil Service (Hauppauge, NY)
- …the unit's forensic accountants/auditors, detectives, and analysts to identify and prosecute financial fraud in the healthcare industry and abuse and neglect of ... Attorney General, Office of the Title Attorney: Investigate/Prosecute Financial Fraud (3789) Occupational Category Legal Salary Grade NS Bargaining...residents in healthcare facilities, present evidence to grand juries, and conduct… more
- Corewell Health (Grand Rapids, MI)
- …experience fraud and abuse experience or equivalent combination of; auditing, healthcare fraud and abuse, compliance, or regulatory (ie, CMS & Medicaid) ... Unit (SIU) with a focus on identifying, investigating, and resolving health insurance fraud , waste, and abuse (FWA). This role provides operational oversight to the… more
- State of Georgia (Fulton County, GA)
- …Georgia Medicaid Program. Participates as a member of an interdisciplinary team in Healthcare fraud investigations, and provides support to members of other ... and eligibility of providers as requested. + Assists prosecutors in Healthcare Fraud investigations by reviewing provider and patient records. + Makes… more
- SGI Global, LLC (Mobile, AL)
- …(or equivalent experience). + Background in law enforcement, forensic accounting, healthcare fraud , civil litigation, or legal investigations. + Experience ... plays a vital role in investigating and developing civil fraud cases and other enforcement actions that protect taxpayer...agencies. + Familiarity with medical billing practices and reviewing healthcare records. + Ability to obtain and maintain a… more
- MyFlorida (Miami, FL)
- …in Miami or West Palm Beach, Florida, and involves auditing complex multi-million-dollar healthcare fraud investigations that can result in criminal and/or civil ... as lead investigator on cases involving suspected Cost Report Fraud and Prospective Payment System Medicaid provider fraud... Fraud and Prospective Payment System Medicaid provider fraud involving: 1) Nursing Homes, 2) Hospitals, and 3)… more
- Amentum (Albany, NY)
- …data analytics. + Support development of internal best practices and workflows for healthcare fraud detection. **Required Qualifications:** + Must be able to ... business entities, and assets. + Analyze large and complex healthcare claims datasets to identify fraud , waste, and abuse patterns. + Design and run SQL… more
- New York State Civil Service (New York, NY)
- …the unit's New York City office. The selected attorney will lead complex civil fraud investigations in the healthcare industry, as well as litigate such matters ... Agency Attorney General, Office of the Title Attorney: Lead Complex Civil Fraud Investigations (3788) Occupational Category Legal Salary Grade NS Bargaining Unit M/C… more
