- CVS Health (Woonsocket, RI)
- …+ A minimum 3 years of experience in a Healthcare Program Integrity, Medicaid Special Investigation or Medicaid / Medicare / Commercial Compliance role + Strong ... Brief Overview** Oversees corporate activities related to the prevention, investigation , and prosecution of health care fraud to recover...Leads a team in the planning and execution of investigations of acts of healthcare fraud and abuse by… more
- State of Massachusetts (Boston, MA)
- …effort toward the improvement of monitoring systems and overall practices for the Special Investigations Unit. This strategic manager collaborates with the ... individual to fill the role of Director for the Special Investigations Unit. In this role, the...for statistical record keeping. * Hold responsibility for protective investigation services for "conflict of interest" situations (DCF staff… more
- The Hartford (Norwood, MA)
- …presentations, working with claims and underwriting, etc. + Work with Risk Engineering Manager on special projects and developing reports to support Regional ... and file reviews, coaching, etc. + Active participation in special projects that could be technical in nature (ie)...the demonstration of operational loss analysis reports and accident investigations used to direct services that would eliminate or… more
- Tufts Medicine (Boston, MA)
- …Military or Law Enforcement experience or ability to become licensed as a Special State Police Officer pursuant to MGL 22c Section 63. **Duties and ... 12. Collaborates with the department's Investigator on conducting follow up investigations of criminal activity and/or policy violations. 13. Collaborates with the… more
- Ryder System (Providence, RI)
- …(http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The Senior Manager Environmental Engineering is responsible for ensuring that ... Director, Environmental Engineering and will supervise Project Engineers and Manager , Environmental Engineering staff, manage Company SPCC, Industrial Waste Water… more
- Point32Health (Canton, MA)
- …**Job Summary** The Investigator I is an essential team member of the Special Investigation Unit ("SIU") responsible for leading complex provider ... will be responsible for conducting high-volume Pre-Payment Fraud Waste & Abuse ("FWA") investigations under the direction of the Manager , FWA Prepayment Review.… more
- Cardinal Health (Providence, RI)
- …therapies to patients who need them-faster.** **_Responsibilities_** The Senior Case Manager supports patient access to therapy through patient support services in ... outcome to de-escalate + Must meet the daily task and benefit investigation goals associated with a high enrollment volume/low patient interaction program. +… more
- Takeda Pharmaceuticals (Boston, MA)
- …to the best of my knowledge. **Job Description** **Title: Senior Manager , Combination Products and Device Manufacturing** **Location: Cambridge, MA** **About the ... role:** As a Senior Manager , Combination Products and Device Manufacturing, you will manage...of manufacturing processes and lead or support deviations and investigations . Additionally, you will serve as a primary technical… more
- Republic Services (Norfolk, MA)
- …and general direction from an Area Director, Human Resources, the Human Resources Manager acts as a business partner with the local management team to effectively ... within the division. + Assists in conducting and resolving investigations regarding employee complaints and concerns. + Participates in...directly applicable experience as an HR Generalist or HR Manager who was involved in all aspects of HR.… more
- JPMorgan Chase (Boston, MA)
- …leading global financial institutions on behalf of our clients. As a Supervisory Manager in JP Morgan Advisors, you will exhibit leadership and operational expertise ... Review client inquiries, issues, and complaints and complete a thorough investigation and provide resolution. This involves Compliance, Legal, Portfolio Management… more
- State of Massachusetts (Boston, MA)
- …prosecution in connection with the DFML programs and operations. * Works on special investigation projects and other related projects that support the goals ... Medical Leave* The Compliance Officer is responsible for conducting investigations for compliance with MGL Chapter 175M and 458...** The Compliance Officer II,who reports to the Senior Manager of Benefit Operations & Program Integrity is based… more
- Point32Health (Canton, MA)
- …safety strategy. The incumbent leads safety and security incident investigations and collaborates with internal and external stakeholders-including corporate ... wellness and safety programs, and serving as a backup to the Senior Manager of Safety & Security. **Job Description** **Key Responsibilities/Duties** **- what you… more
- CVS Health (Woonsocket, RI)
- …are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a leading health insurance organization. This is ... datasets. + Design, develop, and maintain complex data analyses to support investigations of potential fraud, waste, and abuse in Medicaid claims and provider… more
- Travelers Insurance Company (Providence, RI)
- …manage claims by completing essential functions including contacts, investigation , damages development, evaluation, reserving, litigation management, negotiating and ... and stakeholders; take necessary statements, as strategically appropriate. + Complete outside investigation as needed per case specifics. + Actively engage in the… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …regulatory compliance and service excellence. Reporting to the MAPD, Pharmacy Operations Manager and in partnership with the Clinical Manger, this role will have ... external areas. + Participate and present in leader and staff meetings. + Special projects as needed. Key Qualifications: + Demonstrates a commitment to quality and… more
- Eversource Energy (Westwood, MA)
- …as assigned, serve as team or project leader for unique / special engineering assignments\. **Essential Functions:** + Serve as technical specialist to Substation ... design, long range system planning, system analysis, site / safety investigations , structural / material analysis, equipment qualification, code assessment /… more
- BioLife Plasma Services (Attleboro, MA)
- …customer service and quality is expected. You will report to the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse) to ... Center Nurse) works under the guidance of the Center Manager (or Assistant Manager as applicable) for...a Pandemic Coordinator when authorized by EHS and support investigations associated with pandemic threats within the local community… more
- BioLife Plasma Services (Attleboro, MA)
- …customer service and quality is expected. You will report to the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse) to ... Center Nurse) works under the guidance of the Center Manager (or Assistant Manager as applicable) for...a Pandemic Coordinator when authorized by EHS and support investigations associated with pandemic threats within the local community… more
- Integra LifeSciences (Mansfield, MA)
- …This position is under the direct supervision of the Quality Engineering Manager . Works independently under general supervision, reviewed at project milestone and/or ... the business. + Identifies Noncompliance's, works with complaint handling, and CAPA Investigations . + Organizes and manages the plant internal audit system as the… more
- State of Massachusetts (Boston, MA)
- …factors. Under the general direction of the Senior Quality Assurance Manager , the*Quality Assurance Clinical Specialist*supports the Quality Assurance team in ... identified policy and practice concerns. In collaboration with the Senior QA Manager , identifies next steps for resolution and/or OCA intervention if required. *… more