- CVS Health (Sacramento, CA)
- …investigators and analysts to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to ... a team in the planning and execution of investigations of acts of healthcare fraud and abuse by both members and providers. Provides direction and counsel on… more
- Highmark Health (Sacramento, CA)
- …3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations **Preferred** + 1 year in Financial Analysis ... Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider… more
- Centene Corporation (Sacramento, CA)
- …perspective on workplace flexibility. **Position Purpose:** Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, ... executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse. + Conduct investigations of potential waste,… more
- CVS Health (Sacramento, CA)
- …Managers, and Directors as appropriate in matters pertaining to the investigation of suspected healthcare fraud cases. Completion of Fraud waste and abuse ... position will focus on utilization, quality, and review of fraud , waste, and abuse for individual Aetna member cases....resources and technology in developing evidence, supporting allegations of fraud and abuse. + Research and prepare cases for… more
- Elevance Health (Rancho Cordova, CA)
- …for the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds ... pharmacy claims. + Responsible for identifying and developing enterprise-wide specific healthcare investigations that may impact more than one company health plan,… more
- CACI International (Los Angeles, CA)
- …of Justice Criminal Fraud Section attorneys in the litigation of healthcare fraud cases. **Responsibilities:** + Assist trial attorneys with case ... families. At CACI, you will receive comprehensive benefits such as; healthcare , wellness, financial, retirement, family support, continuing education, and time off… more
- Elevance Health (Los Angeles, CA)
- …independent identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client ... claims. + Responsible for independently identifying and developing enterprise-wide specific healthcare investigations and initiatives that may impact more than one… more
- Danaher Corporation (Los Angeles, CA)
- …industry + Drafting, reviewing, and negotiating various types of agreements + US healthcare fraud and abuse laws, rules, regulations, regulatory guidance, and ... various legal issues and associated risks, including transactions with healthcare providers, research institutions, and promotional programs. + Provide… more
- Amgen (Thousand Oaks, CA)
- … healthcare industry is a plus but not required, including counseling on: + Healthcare fraud and abuse matters + OIG compliance guidance and advisory opinions ... price concession strategies and risk mitigation with members of the healthcare community (managed care organizations, hospitals, Group Purchasing Organizations (GPO)… more
- Edwards Lifesciences (Irvine, CA)
- …including US and other medical device regulatory landscape, Advertising and promotion, Healthcare fraud and abuse, Antitrust, Anti-corruption and the US Foreign ... Requirement** Edwards is committed to protecting our vulnerable patients and the healthcare providers who are treating them. As such, all patient-facing and… more