- Option Care Health (Bannockburn, IL)
- …action policies and procedures.Reporting to the VP, Compliance & Privacy Operations , this individual will also assist Compliance leadership with:* Developing and ... all applicable laws, regulations, and internal policies related to healthcare operations .Job Description: Job Responsibilities (listed in order of importance and/or… more
- Franklin Energy (San Francisco, CA)
- …of criminal offenses such as vehicle vandalism and break-ins and staged-accident fraud , defense of legal claims , driver exoneration, and driver training ... for providing expert system and program engineering support to Franklin Energy operations teams, AM Conservation delivery teams, and utility clients. This engineer… more
- Wells Fargo (Chandler, AZ)
- **About this role:** Wells Fargo is seeking a Senior Fraud & Claims Operations Representative in Fraud & Claims Management as part of Consumer & ... Small Business Banking Operations . Learn more about our career areas and lines...ideas for improving or implementing processes and tools within fraud and claims functional area + Perform… more
- M&T Bank (Clanton, AL)
- …clients. Work with these teams to improve internal processes associated with fraud events, including investigations, claims , and coordination of activities. + ... a minimum of 10 years' proven marketing, product management, financial, operations and/or project management experience. *M&T's Fraud Mitigation Program… more
- City National Bank (Newark, DE)
- …3 years in banking operations . + Minimum 2 years of experience in fraud investigations, disputes, and /or fraud exposure. **Skills and Knowledge** + Must ... ** FRAUD DETECTION SPECIALIST I** **Hybrid Schedule 3 days...outbound and/or inbound call, in addition to initiating dispute claims . This position will play a key role in… more
- Axis (Red Bank, NJ)
- …in the selection process. AXIS is seeking a **_Head of Quality Assurance & Compliance, Claims Shared Services_** to join our Shared Services Claims team. As a ... the ability to implement, develop and lead a successful Claims Quality Assurance and Compliance program for Axis ...to internal stakeholders + Assisting with maintenance of SIU, Fraud reporting and other Compliance reporting and procedures as… more
- The Cigna Group (Denver, CO)
- … claims processing capabilities, Evernorth Accountable Care is seeking an experienced Claim Operations senior leader to build a high performing team of claim ... analysts and operations personnel to support the business in ongoing claim operations . **Essential Functions** The Senior Manager of Claim Operations … more
- MyFlorida (Tallahassee, FL)
- SENIOR ATTORNEY - 43000785 Date: Apr 16, 2024...OF THE GENERAL COUNSEL BUREAU: CRIMINAL LAW & FALSE CLAIMS CITY: TALLAHASSEE COUNTY: LEON SPECIAL NOTES: A Juris ... . Requisition No: 827475 Agency: Financial Services Working Title: SENIOR ATTORNEY - 43000785 Pay Plan: SES Position Number: 43000785… more
- State of Massachusetts (Boston, MA)
- …* Reviewing complaints and referrals, including assisting with the day-to-day operations of Office's fraud hotline. * Investigating and documenting ... is an independent agency charged with preventing and detecting fraud , waste and abuse in the use of public...bureaus: Specialty & General Government, Legal & Compliance, and Operations , Training & Publications. Each bureau contains divisions that… more
- Immigration and Customs Enforcement (IN)
- …Assistant Director for Healthcare Compliance, Office of Health Plan Management. The Senior Utilization Review Consultant will report directly to the IHSC Regional ... position Responsibilities DUTIES AND RESPONSIBILITIES: Serves in the capacity of Senior Utilization Review Consultant and subject matter expert in program activities… more
- American Express (New York, NY)
- …of Whistleblower claims , Significant Ethics Violations, and certain instances of Fraud to the Audit and Compliance Committee of the Board of Directors. We ... compliance, technology, operational risk, financial accounting, data analytics, and banking operations . Most IAG team members hold at least one professional… more
- BD (Becton, Dickinson and Company) (San Diego, CA)
- …health care professionals and reimbursement by government programs, including, for example, fraud and abuse (Anti-Kickback Statute, False Claims Act), FDA ... and maintaining valuation models and transactional, diligence and integration processes. The Senior Counsel, Commercial Business Units, will be a member of the… more
- Boehringer Ingelheim (Ridgefield, CT)
- …benefit programs reflect Boehringer Ingelheim's high regard for our employees. The Senior Associate Director, Clinical Data Engineering is the key contact partner in ... Data Quality and Integrity by implementing plausibility checks, anomaly detection, and fraud detection methods in data collection systems. This is a global role… more
- Abbott (Santa Clara, CA)
- …to health care professionals and reimbursement by government programs, for example, fraud and abuse (Anti-Kickback Statute, False Claims Act), FDA regulation ... identify and resolve complex legal issues to support the operations of a global leader in the research, development,...minimal supervision and understand which issues to elevate to senior management and appropriate timing for doing so. +… more
- Bausch Health (Seattle, WA)
- …global regions and with functional departments such as R&D, regulatory, quality, sales, operations & downstream marketing is a must for success in this role. ... competitive landscape, integrate business needs into the product and ensure desired claims are in marketing plan. + Develop comprehensive marketing & launch plans… more
- Leonardo DRS, Inc. (Beavercreek, OH)
- …of conduct to include: conflicts of interests; improper practices; liability and fraud + Understand contract design and structure to include: FFP; CPIF; CPFF; ... IT utilization through electronic commerce and ERP/Oracle implementation + Provide claims and litigation support involving ASBCA and USCFC + General business… more
- Leonardo DRS, Inc. (Fitchburg, MA)
- …of conduct to include: conflicts of interests; improper practices; liability and fraud + Understand contract design and structure to include: FFP; CPIF; CPFF; ... Strong Presentation Skills with ability to adapt to multiple audiences + Provide claims and litigation support involving ASBCA and USCFC + General business … more
- Walmart (Bentonville, AR)
- …in the system reflects in all upstream and downstream systems to ensure claims are processed seamlessly). **Governance & Control:** **Requires knowledge of:** + SOX ... and regulatory; Tax, Transfer Pricing guidelines, international regulatory guidelines + Fraud detection frameworks regarding siphoning of funds, AML, leakage etc;… more
- EFI Global (Orlando, FL)
- …analysis and engineering projects for clients.** **Collaborates with sales and operations managers, architects, developers, insurance adjusters, claims managers ... decades, we have grown from a boutique firm specializing in handling insurance fraud and arson cases and providing expert witness testimony, into a recognized global… more
- Boehringer Ingelheim (Ridgefield, CT)
- …Quality and Integrity by implementing plausibility checks, anomaly detection, and fraud detection methods in data collection systems. Supports the clinical research ... Project/Trial level technical specifications for new substances, indications or marketing claims .As an employee of Boehringer Ingelheim, you will actively contribute… more
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