- Elevance Health (Gilbert, MN)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days ... week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office… more
- Manulife (Workman, MN)
- …: + Successfully completes high-quality, sophisticated long term care claims investigations + Independently develops and drives a detailed investigative ... + Acquires and reviews internal / external documents to support investigative activity and findings + Conducts interviews of...and trains more junior investigators on long term care claim cases and processes + Ability to travel on… more
- CVS Health (St. Paul, MN)
- …States. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), dedicated to a ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants, and customers. + Research and… more
- Humana (St. Paul, MN)
- …with law enforcement authorities. Assembles evidence and documentation to support successful adjudication, where appropriate. Conducts on-site audits of provider ... Certifications, CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + Experience in a corporate… more
- Otsuka America Pharmaceutical Inc. (St. Paul, MN)
- …the clinical development plans. + Review and approval of clinical study protocols, investigator brochures, study reports, etc. + Support budget and timeline ... and translational tools, new technologies and scientific capabilities in support of Otsuka's pipeline. The Senior Director TM works...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Otsuka America Pharmaceutical Inc. (St. Paul, MN)
- …+ Working closely in collaboration with the Global Medical Evidence Ops lead, support the design, execution, and reporting of studies to support generation ... of medical evidence, (eg, observational studies, registries, and investigator -initiated studies (IISs) / investigator -initiated trials (IITs)) + Manage study… more
- Otsuka America Pharmaceutical Inc. (St. Paul, MN)
- …congress planning & execution educational programs, and evidence-based content that support Otsuka's mission to improve patient outcomes through deep scientific ... data dissemination plans are timely, consistent, and strategically aligned + Support scientific communication planning across global and regional teams to ensure… more
- Abbott (Maple Grove, MN)
- …and process changes, to gain regulatory approval for product release, additional claims or indications, by addressing issues from a clinical, medical, and scientific ... the execution of the publication strategy through coordination with investigator authors and internal teams. + Serve as an...an active member of study teams and provide scientific support to justify trial design and ongoing scientific analysis… more