- LA Care Health Plan (Los Angeles, CA)
- …Field Experience Required: At least 7 years of experience in healthcare compliance, fraud investigations , law enforcement, or related field. At least 5years of ... Director, Compliance on Special Investigations Unit and Fraud , Waste and...(DHCS), and state/federal requirements. Ensure effective case intake, triage, investigation , tracking, and resolution processes, including referral to law… more
- Humana (Sacramento, CA)
- …part of our caring community and help us put health first** The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive ... schedules and goals. **Where You Come In** The Manager, Fraud and Waste coordinates investigation with law...In** The Manager, Fraud and Waste coordinates investigation with law enforcement authorities. Assembles evidence and documentation… more
- Gilead Sciences, Inc. (Foster City, CA)
- … investigations of alleged misconduct, including matters related to fraud , conflicts of interest, inappropriate interactions with healthcare professionals, misuse ... of patients with life-threatening illnesses worldwide. **Director, Ethics and Compliance Investigations ** **About the Role** The Director, Ethics & Compliance … more
- Deloitte (San Francisco, CA)
- … experience when supporting an engagement team in their understanding of a client's fraud investigation and its impact on the financial statement audit. When ... employment + 8+ years of experience in auditing, forensic accounting, including accounting investigations or proactive fraud risk services + Experience in public… more
- City National Bank (Los Angeles, CA)
- …tools to investigate, research, and prepare documentation related to fraud investigations consistent with the resolution of the investigation and perform ... management or fraud related functions * Minimum 5 years experience in fraud investigations *Additional Qualifications* * Must work well in a team… more
- LinkedIn (Mountain View, CA)
- …Engineering and Investigators to create cutting-edge technologies to fight abuse and fraud at scale. This role focuses on building proactive detection and incident ... strategies, and cohesive defensive workflows. 12. Represent the Incident Response and Investigations teams to Senior leaders across the company. 13. Innovation &… more
- Elevance Health (Costa Mesa, CA)
- …prior to payment. Researches new healthcare-related questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other ... clinical evaluation of the collected data. + Performs in-depth investigations on identified providers as warranted. + Examines claims...including minimum of 1 year experience in a Clinical Fraud and Abuse Investigation area; or any… more
- ADP (San Dimas, CA)
- …to provide updates and recommendations + Mentor colleagues and share best practices in fraud investigation and analytics + Act as a resource for project-oriented ... **Apply now!** **WHAT YOU'LL DO:** Responsibilities + Conduct in-depth investigations of complex fraud cases, using advanced...days at home).** + 5+ years of experience in fraud investigation , risk management, or compliance +… more
- Humana (Sacramento, CA)
- …time zones **Required Qualifications** * Bachelor's degree * 2 years of healthcare fraud investigations and auditing experience * Knowledge of healthcare payment ... you should strongly consider this amazing opportunity to join Humana's SIU. The Fraud and Waste Professional conducts investigations of allegations of fraudulent… more
- Zoological Society of San Diego (Escondido, CA)
- …develop and implement conservation initiatives. WHAT WE ARE LOOKING FOR Disease Investigations ' mission is to remove disease as a roadblock to wildlife conservation. ... problems by carrying out comprehensive disease surveillance programs, disease outbreak investigations , and targeted disease research for the animals in our… more