- Molina Healthcare (Owensboro, KY)
- …opinions. + Knowledge of investigative and law enforcement procedures with emphasis on fraud investigations . + Knowledge of Managed Care and the Medicaid and ... Healthcare Services, Member Services, Claims) to gather documentation pertinent to investigations . + Detects potential health care fraud , waste, and… more
- Prime Therapeutics (Frankfort, KY)
- …& Experience** + Education Level Bachelors + Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the ... for work visa or residency sponsorship. **Additional Qualifications** + 3+ years' fraud investigations /claims experience. + Ability to manage workload while… more
- Allied Universal (Louisville, KY)
- …(5) years of demonstrated professional law enforcement experience with specific attention to investigations related to fraud + Ability to be properly licensed as ... and Paid Holidays (FT only)** Allied Universal(R) is hiring a Special Investigations Unit (SIU) Investigator. Special Investigations Unit (SIU) Specialists… more
- CVS Health (Frankfort, KY)
- …Medicaid experience is preferred. Leads a team in the planning and execution of investigations of acts of healthcare fraud and abuse by both members and ... **Required Qualifications** + 2 to 5 years of managing healthcare fraud , waste and abuse investigations and audits. + 3 to 5 years of leadership experience… more
- Molina Healthcare (KY)
- …SIU an active relationship with third parties who have specific experience in conducting fraud and abuse investigations . * Prepares written reports to inform the ... accountability for compliance by overseeing, follow-up and resolution of investigations . **Knowledge/Skills/Abilities** * Responsible for oversight and management of… more
- Molina Healthcare (KY)
- …(PSOC) Team. Responsible for the monitoring and intelligence, incident response, and investigations programs which are in place to avoid business disruption, threats ... as possible. **Job Duties** + Responsible for operational physical security, investigations , and incident response for the enterprise to proactively monitor,… more
- Command Investigations (Louisville, KY)
- Command Investigations LLC is a dynamic and forward-thinking investigative company that has been at the forefront of the industry since its establishment in ... as a leader in the investigation industry. At Command Investigations , we take pride in our proven track record...+ Minimum of 1 year experience relating to Work Compensation/ Fraud /Mobile and Stationary surveillance + Be able to hold… more
- Molina Healthcare (Covington, KY)
- …accountability for compliance by overseeing, follow-up and resolution of investigations . **KNOWLEDGE/SKILLS/ABILITIES** + Provides oversight and review of the SIU ... + Works with leadership to maintain and revise policies and procedures, fraud , waste, and abuse plans, annual audit work plans, including department guidance… more
- Otsuka America Pharmaceutical Inc. (Frankfort, KY)
- …manufacturing operations at CDMOs, including review of batch records, deviation investigations , and change controls. + Lead or significantly contribute to ... troubleshooting efforts and root cause investigations for upstream process deviations or performance issues at CDMOs. + Analyze upstream process data (via CPV… more
- Otsuka America Pharmaceutical Inc. (Frankfort, KY)
- …manufacturing operations at CDMOs, including review of batch records, deviation investigations , and change controls. + Lead or significantly contribute to ... troubleshooting efforts and root cause investigations for downstream process deviations or performance issues at CDMOs. + Analyze downstream process data (via CPV… more