- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Fraud and Waste Professional 2 is responsible for conducting comprehensive investigations of ... reported, alleged or suspected fraud involving Florida's Medicaid Program. The Fraud and Waste Professional 2 coordinates investigation with law enforcement… more
- Molina Healthcare (Fort Worth, TX)
- …ASSOCIATION** : + Health Care Anti- Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all ... investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste , and abuse. Duties include performing accurate and reliable… more
- CVS Health (Austin, TX)
- …the United States. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), ... manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + Conduct high level, complex… more
- Molina Healthcare (Houston, TX)
- …delivery systems + Understanding of datamining and use of data analytics to detect fraud , waste , and abuse + Proven ability to research and interpret regulatory ... position must have the ability to determine correct coding, documentation, potential fraud , abuse, and over utilization by providers and recipients. The position… more
- Aramco Services Company (Houston, TX)
- …be completed. + Conducts objective, thorough, and timely investigations into allegations of fraud , waste or abuse committed by employees or contractors against ... assignments beyond the normal scope of the audit function. The Senior Lead Investigator handles hotline reports or calls and manages cases of moderate to high… more
- Texas A&M University System (College Station, TX)
- …the Ethics and Compliance Lead Investigator to conduct complaint investigations regarding fraud , waste , and abuse. + Management Review Team: serves as a ... member of the team traveling to Research and Extension centers. Review UAS, fleet, inventory, and conducts physical security assessments. + Monitors the Unmanned Aircraft Systems (UAS) Program, including ensuring applications and flight scheduled are complete… more