- State of Minnesota (St. Paul, MN)
- **Working Title: Medicaid Provider Audits and Investigations Manager** **Job Class: Human Services Manager 2** **Agency: Human Services Dept** + **Job ... The incumbent manages anti-fraud, waste, and abuse efforts, including provider investigations , prevention, education, and enforcement activities.… more
- CVS Health (St. Paul, MN)
- …accreditation from the National Health Care Anti-Fraud Association (AHFI) + Experience In Medicaid Compliance, Medicaid Investigations , MCO Medicaid FWA ... comply with state regulations mandating fraud plans and reporting; Medicaid experience is preferred. Leads a team in the...5 years of managing healthcare fraud, waste and abuse investigations and audits . + 3 to 5… more
- Humana (St. Paul, MN)
- …and documentation to support successful adjudication, where appropriate. Conducts on-site audits of provider records ensuring appropriateness of billing ... The individual in this position acts as the primary liaison for the Virgina Medicaid . They coordinate all Medicaid FWA activities in Virgina to enhance the… more
- Humana (St. Paul, MN)
- …and documentation to support successful adjudication, where appropriate. Conducts on-site audits of provider records ensuring appropriateness of billing ... help us put health first** The Senior Fraud and Waste Professional conducts investigations of allegations of fraudulent and abusive practices. The Senior Fraud and… more
- Humana (St. Paul, MN)
- …initiatives. + Monitor and interpret legislative and regulatory changes. + Support audits , investigations , and responses to regulatory inquiries. **Use your ... pharmacy benefit manager and pharmacy in the following areas: + Provide legal support for strategic initiatives, including contract negotiations with pharmaceutical… more