- Humana (Frankfort, KY)
- …to include multiple practice areas + At least 2 years of healthcare fraud investigations and auditing experience + Knowledge of healthcare payment methodologies ... Fraud and Waste Professional 2 is responsible for conducting comprehensive investigations of reported, alleged or suspected fraud involving Florida's Medicaid… more
- Deloitte (Louisville, KY)
- …employment + 8+ years of experience in auditing, forensic accounting, including accounting investigations or proactive fraud risk services + Experience in public ... and curious individual with a record of accomplishment leading fraud and forensics services? At Deloitte, we have a...When situations require our audit clients to undertake independent investigations , you will be part of a team performing… more
- Humana (Frankfort, KY)
- …part of our caring community and help us put health first** The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive ... practices. The Manager, Fraud and Waste works within specific guidelines and procedures;...schedules and goals. **Where You Come In** The Manager, Fraud and Waste coordinates investigation with law enforcement authorities.… more
- Molina Healthcare (Covington, KY)
- …from opinions + Knowledge of investigative and law enforcement procedures with emphasis on fraud investigations + Knowledge of Managed Care and the Medicaid and ... company + Minimum of two (2) years' experience working on healthcare fraud related investigations /reviews + Proven investigatory skill; ability to organize,… more
- Centene Corporation (Frankfort, KY)
- …may substitute for the Bachelors Degree . 5+ years of management experience Investigations and healthcare fraud -related investigations with audit and risk ... a subject matter expert for the Contractor's Program Integrity unit to reduce Fraud , Waste and Abuse of Medicaid services within Kentucky. Provides direction and… more
- Executive Office for US Attorneys and the Office of the US… (Lexington, KY)
- …Affirmative civil enforcement AUSAs regularly collaborate with criminal AUSAs in fraud investigations that involve criminal and civil components. Whether ... that violate the False Claims Act by engaging in fraud against the federal government (including health care ...fraud against the federal government (including health care fraud , financial fraud , and procurement fraud… more
- Cardinal Health (Frankfort, KY)
- …processes and control procedures and manages Sarbanes-Oxley (SOX) compliance and fraud investigations . **_Responsibilities_** + Assist in leading efforts of ... managing and executing the SOX program including identifying, performing testing, and review of SOX controls, while working with and maintaining relationships with business. + Work directly with and perform substantive audit procedures on the behalf of our… more
- Coinbase (Frankfort, KY)
- …* Lead a team of 10-15 Compliance (Transaction Monitoring / AML and Fraud Investigations /EDD) Analysts; * Ensure adherence to operational KPIs from directs ... and vendor partners or overall performance and the quality. * Coordinate with senior management and provide insights for process improvement. * Communicate effectively with your team to drive individual and group performance. * Champion change management with… more
- Coinbase (Frankfort, KY)
- …, identify patterns, and find the root cause. * A passion for fighting fraud . * The curiosity to self-drive investigations , identify patterns, and find the ... closely with sub-teams focused on areas like risk modeling, fraud detection, and analytics. The goal of these partnerships...rule performance and risk logic to corresponding Payments Risk investigations teams *What we look for in you (ie.… more
- CVS Health (Frankfort, KY)
- …healthcare datasets. + Design, develop, and maintain complex data analyses to support investigations of potential fraud , waste, and abuse in Medicaid claims and ... who can transform complex healthcare data into actionable insights to support fraud , waste, and abuse (FWA) detection and Medicaid regulatory & compliance reporting.… more