- Humana (Providence, RI)
- …a part of our caring community and help us put health first** The Manager , Fraud and Waste Investigator: Nurse Audit/Review performs clinical ... of objectives and determines approach, resources, schedules and goals. The Manager , Fraud and Waste Investigator: Nurse Audit/Review validates and interprets… more
- CVS Health (Woonsocket, RI)
- …in federal and state audits. **Required Qualifications** + 2 to 5 years of managing healthcare fraud , waste and abuse investigations and audits. + 3 to 5 ... Brief Overview** Oversees corporate activities related to the prevention, investigation , and prosecution of health care fraud ...Leads a team in the planning and execution of investigations of acts of healthcare fraud and… more
- Point32Health (Canton, MA)
- …for conducting high-volume Pre-Payment Fraud Waste & Abuse ("FWA") investigations under the direction of the Manager , FWA Prepayment Review. The ... Investigation Unit ("SIU") responsible for leading complex provider investigations related to fraud , waste ,...every day! + Other duties as assigned by the Manager , Pre-Payment Review Qualifications - what you need to… more
- CVS Health (Woonsocket, RI)
- …large healthcare datasets. + Design, develop, and maintain complex data analyses to support investigations of potential fraud , waste , and abuse in Medicaid ... Python who can transform complex healthcare data into actionable insights to support fraud , waste , and abuse (FWA) detection and Medicaid regulatory & compliance… more