- RHA Health Services (High Point, NC)
- …retaliation policies. Directs the confidential and immediate investigation into allegations of abuse , neglect, exploitation, theft, fraud , waste , misconduct, ... We are hiring for: Care Manager / IDD / Davidson / Guilford /...Name checked in the registries. (OIG exclusions database, Child Abuse Registry, and Offenders Against Individuals with Developmental Disabilities)… more
- City of Minneapolis, MN (Minneapolis, MN)
- …tracking in audit software Serve as detail reviewer on audit projects Assist with fraud , waste , or abuse investigations Validate client responses to audit ... consideration. This list will be certified to the hiring manager who may use the list to fill a...experience do you have conducting an investigation related to fraud , waste , and abuse ? No… more
- Veterans Health Administration (Philadelphia, PA)
- …and monitors expenditures to support recurring budget forecasts and identify potential fraud , waste and abuse based on procurement history ... process); gain additional knowledge regarding a candidate's abilities; and assist a hiring manager with making a final selection for a position. For more information… more
- Morgan Stephens (Houston, TX)
- …system. Additionally, the RN will be responsible for identifying and reporting suspected fraud , waste , and abuse . Key Responsibilities: Review and validate ... Job Title: Remote Hospice Telephonic Case Manager Pay Rate: $80,000-$90,000 Schedule: Monday - Friday,...pseudo authorizations into the managed care system. Report suspected fraud , waste , and abuse as… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- The Manager , Fraud , Waste & Abuse (FWA) provides leadership and oversight of the FWA area. The position involves the management of the FWA Program in ... and work plan + Lead special investigations + Research, investigate and report fraud , waste and abuse cases + Utilize internal system, external platforms and… more
- CenterWell (Boise, ID)
- …2 is responsible for conducting comprehensive investigations of reported, alleged, or suspected fraud , waste , or abuse . This role involves varied work ... departments to identify trends and analyze claims for potential fraud , waste , and abuse (FWA),...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- MyFlorida (Tallahassee, FL)
- …a broad scope of data analytics to proactively identify qualified leads for potential fraud , waste , and abuse (FWA) investigations. The selected candidate ... collaboration with the team and the Program Integrity Unit Manager , draft investigative work plans and develop case strategies...reports and statistical/financial analysis to support findings of potential fraud , waste , and abuse . +… more
- Corewell Health (Grand Rapids, MI)
- …Unit (SIU) with a focus on identifying, investigating, and resolving health insurance fraud , waste , and abuse (FWA). This role provides operational ... Job Summary - Manager Special Investigation Unit The SIU Manager...Unit (SIU), ensuring timely and thorough investigation of potential fraud , waste , and abuse (FWA)… more
- Elevance Health (Hanover, MD)
- …errors. Works with health plan leaders, oversees the monitoring and enforcement of the fraud , waste , and abuse compliance program to prevent and detect ... **Carelon Medical Coding/Auditing Manager - Behavioral Health** **Supports Payment Integrity &...potential fraud , waste , and abuse activities pursuant to state… more
- Elevance Health (Pittsburg, KS)
- …errors. Works with health plan leaders, oversees the monitoring and enforcement of the fraud , waste , and abuse compliance program to prevent and detect ... **Carelon Payment Integrity Manager ** _Hybrid 1: This role requires associates to be...potential fraud , waste , and abuse activities pursuant to state and… more
- MTA (Jamaica, NY)
- …to deliver an effective and efficient Internal Control Review program that roots out fraud , waste and abuse . Additionally, this role will be responsible ... Compliance Manager Job ID: 9516 Business Unit: MTA Headquarters...efficiency and effectiveness to help safeguard company assets, reduce fraud , waste and abuse , provide… more
- MTA (New York, NY)
- …to deliver an effective and efficient Internal Control Review program that roots out fraud , waste , and abuse . Additionally, this role will be responsible ... Compliance Manager Job ID: 11531 Business Unit: MTA Headquarters...efficiency and effectiveness to help safeguard company assets, reduce fraud , waste and abuse , provide… more
- Coast Guard Community Services Command (Chesapeake, VA)
- …followed, and identify, mitigate and develop action plans to address any potential issues of fraud , waste and abuse . You'll be the subject matter expert on ... Coordination: Liaise with local, state, and federal law enforcement agencies on matters of fraud , waste , and abuse . Establish and execute action plans for… more
- US Marine Corps (Oceanside, CA)
- …of funds, merchandise, supplies and equipment to preclude or minimize the potential for fraud , waste or abuse . Plan, organizes work, and manages internal ... funds, merchandise, supplies and equipment to preclude or minimize the potential for fraud , waste and abuse . Provides World Class Customer Service with an… more
- Molina Healthcare (Owensboro, KY)
- …steps and actions. + Works with leadership to maintain and revise policies and procedures, fraud , waste , and abuse plans, annual audit work plans, including ... License, Certification, Association + Active and unrestricted Accredited Health Care Fraud Investigator (AHFI) designation or Certified Fraud Examiner (CFE)… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …are professional employees with a good working knowledge of investigations of complaints of fraud , waste and abuse involving state and local public funds. ... Auditors will generally be assigned to investigate complaints of fraud , waste , and abuse of...+ Participate in team meetings. + Keep AIC and/or Manager informed of relevant information. + Assis in the… more
- US Marine Corps (Twentynine Palms, CA)
- …of funds, merchandise, supplies and equipment to preclude or minimize the potential for fraud , waste and abuse . Provides World Class Customer Service with ... requisitioning, training, directing and assisting staff. Coordinates with catering manager regarding parties, banquets, and protocol functions for kitchen… more
- Sanford Health (Sioux Falls, SD)
- …activities to sustain high quality performance. Oversees pharmacy department participation in the VIPS fraud , waste , and abuse process and the Health Plan ... Schedule:** Full time **Weekly Hours:** 40.00 **Job Summary** The Manager works closely with Health Plan providers and staff...Special Investigative Unit team to reduce waste and ensure member safety. Serves on integrated health… more
- Commander, Navy Installations (Honolulu, HI)
- …and improvements, and ensures the safeguarding of funds, merchandise, and equipment to prevent fraud , waste , and abuse . Monitors for alcohol abuse ... (CNRH); Honolulu, Hawaii. Incumbent serves as a (Bowling Center Manager ) providing overall management, operational efficiency, program development, staff… more
- NANA Regional Corporation (Mechanicsburg, PA)
- …+ Exemplary attention to detail + Maintains sensitivity to, and report on, instances of fraud , waste and abuse + Demonstrated knowledge of project management ... This position is responsible to the company President/General Manager for the direction, safe operation, compliance, quality...modified budgets, strategic plans, or policies. The PM Contract Manager is responsible for work efforts focused on five… more
