- Eisai, Inc (Nutley, NJ)
- …benefits healthcare provides to patients, their families, and caregivers is Eisai's human health care (hhc) mission. We're a growing pharmaceutical company that ... as the legal representative for market access materials on promotional review committees.Proactively informs assigned business client of important legal, enforcement… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …assist with development of policies and training as needed Advising on interactions with health care providers, patients, and payors in compliance with fraud ... to advise on cross-functional initiatives including promotional and other material review committees Additional areas of responsibilities may include, but are not… more
- DriveTime (Mesa, AZ)
- …for our customers. **That's Nice, But What's the Job?** In short, as the Fraud Coordinator (Loan Review ), you will critically review customer documents, ... data, and investigation tools to assess potential fraud exposure and communicate with our Retail stores on...our money where our mouth is. + **Wellness Program.** Health is wealth! This program includes self-guided coaching and… more
- CVS Health (Hartford, CT)
- …consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions ... At CVS Health , we're building a world of health...**Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna… more
- RELX INC (Atlanta, GA)
- …Benefits, including bonding and family care leaves, adoption and surrogacy benefits + Health Savings, Health Care , Dependent Care and Commuter ... role with a technical and analytics bent. Responsibilities + Review suspicious activity and complex fraud cases...of the benefits we are delighted to offer: + Health Benefits: Comprehensive, multi-carrier program for medical, dental and… more
- Charles Schwab (Lone Tree, CO)
- …is to protect our client's and the firm's assets by preventing and mitigating fraud losses by utilizing various tools and vendor solutions such as Enterprise Risk ... Engine (Actimize), ThreatMetrix, OASIS, Visa Fraud Modeling, and other vendor Models. TRIAD is responsible...works closely with our model product owners, Schwab Model Review Oversight organization, Internal Audit teams, and our business… more
- ADP (San Dimas, CA)
- …the business unit fraud strategy in the following key areas: + Oversight and review of Fraud processes for the ADP Wisely product sets, including the related ... **ADP is hiring a SR. Director, Compliance Design ( Fraud Investigations) in our Employee Financial Solutions organization.**...your life more easily. + **Focus on your mental health and well-being.** We're here to provide exceptional service… more
- TTEC (Concord, NC)
- …fraudulent activities? You'll review and analyze cases to prevent and detect fraud . You'll work to resolve issues and protect the interests of the client and ... potential has a place here with TTEC's award-winning employment experience. As a ** Fraud Detections Representative working onsite in Concord, NC** you'll be a part… more
- Fannie Mae (New York, NY)
- …red flags to prevent the enterprise from acquiring loans with potential fraud , deficient property values or increased borrower exposure risk. *THE IMPACT YOU ... WILL MAKE* The *Multifamily Underwriting - Fraud Prevention, Principal* role will offer you the flexibility...each day your own, while working alongside people who care so that you can deliver on the following… more
- Commerce Bank (Kansas City, MO)
- …to branch personnel or customer the reason why an item is being flagged for further review and upon confirmation of fraud , next steps in an attempt to recover ... and making sure people and their money are taken care of. And our commitment doesn't stop there. Our...involving Check, ACH, Wire, and Online Banking Bill Payment fraud . Essential Functions + Prevent, investigate, recover potential … more
- Ally (Tallahassee, FL)
- …dreams, and causes that are all important to them. Our focus is on the health and safety of our teammates as well as work-life balance and diversity and inclusion. ... evolving, so shouldn't your opportunities be, too? **The Opportunity** The Fraud Early Warning Analyst position is responsible to assess various situations… more
- Comerica (Farmington Hills, MI)
- …such as life insurance, AD&D, and supplemental health programs to offset unexpected health care expenses. We also have a variety of time off programs for ... Description Fraud Prevention Analyst Identify fraudulent situations through the review of suspicious activity reports and / or alerting systems. Initiate… more
- Amentum (Baltimore, MD)
- + Review data from vendors who provide health care services paid by the federal government to identify anomalies that might be indicative of improper billing ... or other types of fraud . + Initiate contacts with federal, state, and local...+ Experience in document analysis, particularly in relation to fraud cases. + Two years' experience in performing on-line… more
- MyFlorida (Tallahassee, FL)
- …or other criminal violations for law enforcement investigation. This Medical Health Care Program Analyst position will support the fraud and abuse prevention ... 68064376 - MEDICAL/ HEALTH CARE PROGRAM ANALYST Date: Jul...is to ensure fewer budgeted dollars are lost to fraud , abuse, and waste. The Bureau of Medicaid Program… more
- MyFlorida (Miami, FL)
- AUDIT EVALUATION & REVIEW ANALYST - 41000827 Date: Jul 21, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... of the Attorney General Working Title: AUDIT EVALUATION & REVIEW ANALYST - 41000827 Pay Plan: Career Service Position...the Office of the Attorney General within the Medicaid Fraud Control Unit in Miami or West Palm Beach,… more
- CVS Health (Jefferson City, MO)
- …of fraud and abuse **Required Qualifications** + 1 year experience working on health care fraud , waste, and abuse investigatory and audits required. + ... - Researches and prepares cases for clinical and legal review . - Documents all appropriate case activity in case...etc. **Preferred Qualifications** + 1-3 years experience working on health care fraud , waste, and… more
- CVS Health (Annapolis, MD)
- …- Bachelor's degree and/or an Associate's degree with three additional years working in health care fraud , waste, and abuse investigations and audits. ... - Researches and prepares cases for clinical and legal review . - Documents all appropriate case activity in tracking... Examiners (CFE) - An accreditation from the National Health Care Anti- Fraud Association (AHFI).… more
- LA Care Health Plan (Los Angeles, CA)
- …Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state ... Care 's mission is to provide access to quality health care for Los Angeles County's vulnerable...each quarter and annually. Primarily responsible for the creation, review , and submission of departmental policies and procedures annually.… more
- City of New York (New York, NY)
- …found to be eligible can use coverage provided to access doctors, medication and other health care services at little or no cost. The Medical Assistance Program ... the three divisions keep pace with changes relating to health care reform and anticipated program growth...responsibility areas. - Identify areas of vulnerability for committing fraud , and program changes through the monthly statistics and… more
- Corewell Health (Grand Rapids, MI)
- …equivalent experience with a managed care payer. Preferred + Preferred + CRT-Accredited Health Care Fraud Investigator (AHFI) - NHCAA National Health ... (SIU) with a focus on identifying, investigating, and resolving health insurance fraud , waste, and abuse (FWA)....health system, we advocate for equity as we care for our patients, our communities, and each other.… more
