- Highmark Health (Sacramento, CA)
- …incumbent is also responsible for the field investigative work necessary to complete a review of a special project, potential fraud , waste and abuse case, ... + 3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations...+ 1 year in Financial Analysis in an acute care hospital or health insurance setting +… more
- LA Care Health Plan (Los Angeles, CA)
- …Range: $77,265.00 (Min.) - $100,445.00 (Mid.) - $123,625.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state ... Care 's mission is to provide access to quality health care for Los Angeles County's vulnerable...each quarter and annually. Primarily responsible for the creation, review , and submission of departmental policies and procedures annually.… more
- CVS Health (Sacramento, CA)
- …consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions ... At CVS Health , we're building a world of health...protect patient well-being. As the Medical Director of Healthcare Fraud Investigations, you'll lead our efforts to detect, prevent,… more
- Option Care Health (Sacramento, CA)
- …home infusion provider, there is no limit to the growth of your career.** Option Care Health , Inc. is the largest independent home and alternate site infusion ... Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion ...with a strong focus on preventing, detecting, and addressing fraud , waste and abuse (FWA). This leader promotes a… more
- Banc of California (Santa Ana, CA)
- …TOGETHER WE WIN(R) **THE OPPORTUNITY** Responsible for reviewing deposits and managing fraud alerts from multiple sources. Depending on the area this position ... assists management in making strategic decisions and implementing objectives related to fraud prevention. Ensures all duties are performed in compliance with company… more
- Highmark Health (Sacramento, CA)
- …This job is responsible for assisting in the processing and investigation of non-complex health care claims to determine the legitimacy of claim charges. The ... claims and related documents requiring investigations based on pre-determined criteria, including review of suspect claims, Fraud Hot Line and internal… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- **About Otsuka Precision Health ** Founded on Otsuka's rich history in delivering breakthrough innovations to solve complex problems for patients, Otsuka Precision ... Health (OPH) is the next step in our evolution. We are a...do our part to fix some of the fragmentation in care delivery. The time is now. **What you will do (Job… more
- Veterans Affairs, Veterans Health Administration (Los Angeles, CA)
- …patient care encounters (inpatient and outpatient) covering the full range of health care services provided by the VAMC. Patient encounters are often ... Inpatient duties consist of the performance of a comprehensive review of documentation within the health record...is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). Qualifications Basic Requirements:… more
- Cardinal Health (Sacramento, CA)
- …by federal, state or local law._ _To read and review this privacy notice click_ here (https://www.cardinalhealth.com/content/dam/corp/email/documents/corp/cardinal- ... oversight, leadership and direction within the Legal function. **_Job Summary_** Cardinal Health is seeking a driven and skilled attorney with expertise in… more
- Navy Federal Credit Union (San Diego, CA)
- …sensitive situations using appropriate and tactful customer service communications + Review client account(s) and activities, assess needs, apply targeted questions ... opportunities, and increase product penetration + Identify account irregularities, potential fraud and abuse, governed by Bank Secrecy Act (BSA)/Anti- Money… more