- New York State Civil Service (Albany, NY)
- …auditors, detectives, data analysts, and legal support analysts, to conduct complex, long-term healthcare fraud and patient abuse and neglect investigations. ... Agency Attorney General, Office of the Title Legal Nurse: Investigate Medicaid Fraud /Patient Abuse (6399) Occupational Category Legal Salary Grade NS Bargaining… more
- CVS Health (Harrisburg, PA)
- …conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse , to recover lost funds, ... 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 (Charleston, WV)
- …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
- New York State Civil Service (Mineola, 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 (3818) Occupational Category Legal Salary Grade NS… more
- New York State Civil Service (New York, 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 (3819) Occupational Category Legal Salary Grade NS… more
- Centene Corporation (Sacramento, CA)
- …fresh perspective on workplace flexibility. **Position Purpose:** Investigate allegations of potential healthcare fraud and abuse activity. Assist in ... claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse . + Conduct investigations of potential waste,… more
- CVS Health (Hartford, CT)
- …investigations to effectively pursue the prevention, detection, investigation and prosecution of healthcare fraud , waste, and abuse . Also reports suspected ... **Fundamental Components:** - Conducts investigations of known or suspected acts of healthcare fraud , waste, and abuse - Communicates with federal, state,… more
- CVS Health (Albany, NY)
- …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
- Highmark Health (Pittsburgh, PA)
- …create reports, graphs, and charts to timely identify trends and patterns of potential healthcare fraud , waste and abuse . Communicate findings to company ... provider relations, reimbursement etc. + Calculate overpayments in established fraud , waste or abuse cases. Identify all...7 years of in the Health Insurance industry and/or Healthcare Fraud investigations + 3 years in… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …proposes new methods of data analytics and healthcare informatics to discover Fraud , Waste and Abuse activities as well as provide program-wide trend ... Healthcare Administration, Statistics, or a related field) preferred. + Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI),… 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
- AbbVie (Florham Park, NJ)
- …legal issues, including advertising, promotion, antitrust, market access, pricing, reimbursement, healthcare fraud , abuse , and anti-bribery, for both ... on-market and pipeline products. The primary focus is on international strategic priorities, and this role reports directly to the Senior Counsel for IMCO and IMAP. Key Responsibilities Include: + Serve as the strategic and legal lead counsel for… more
- New York State Civil Service (Syracuse, NY)
- …data analysts, and legal support analysts to conduct complex, long-term healthcare fraud investigations. The Medicaid program provides health coverage ... Agency Attorney General, Office of the Title Legal Nurse: Investigate Medicaid Fraud /Patient Abuse (6401) Occupational Category Legal Salary Grade NS Bargaining… more
- Philips (Malvern, PA)
- … Healthcare Compliance professional. This experience would ideally be in the areas of Healthcare Fraud and Abuse and other laws pertaining to interactions ... a focus on identifying and addressing risks related to participation in federal healthcare programs. + Assist and support Compliance Officers and team members in… more
- Amgen (Thousand Oaks, CA)
- …in healthcare industry is a plus but not required, including counseling on: + Healthcare fraud and abuse matters + OIG compliance guidance and advisory ... price concession strategies and risk mitigation with members of the healthcare community (managed care organizations, hospitals, Group Purchasing Organizations (GPO)… more
- WellSpan Health (York, PA)
- …legal advice related to, the full range of healthcare laws, including healthcare fraud and abuse laws, hospital/physician issues, complex contract ... Education:** + Doctor of Law (JD) Required **Work Experience:** + 10+ years Healthcare law experience required + Corporate law experience required + In-house counsel… more
- Amgen (IL)
- …+ Experience counseling clients on complex legal and regulatory considerations including: + Healthcare fraud and abuse matters + FDA promotional regulations ... on price concession strategies and risk mitigation with members of the healthcare community, with emphasis on the Anti-Kickback Statute and applicable antitrust laws… more
- State of Georgia (Fulton County, GA)
- …limited to, Analysts, Auditors, and Prosecutors in conducting on-site health care fraud and patient abuse investigations. Develops necessary knowledge and skills ... to assignments and requests for assistance in health care fraud and patient abuse investigations in a...Healthcare Administration, Accounting, Business and Finance. * Certified Fraud Examiner * Digital Forensics Experience * Law enforcement… more
- CVS Health (Hartford, CT)
- …to work independently and manage multiple priorities **Preferred Qualifications** + Experience in healthcare fraud , waste and abuse + Proficient with ... Microsoft Office suite of products + Experience with SharePoint site development and administration + Familiarity with access control and user permission management **Education** + Bachelor's degree or equivalent experience **Anticipated Weekly Hours** 40… more
- Elevance Health (Richmond, VA)
- …responsible for identifying issues and/or entities that may pose potential risks associated with fraud and abuse . **How you will make an impact:** + Performs ... billing and processing guidelines and to identify opportunities for fraud and abuse prevention and control. +...claims and medical records prior to payment. Researches new healthcare -related questions as necessary to aid in investigations. +… more