- 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
- Executive Office for US Attorneys and the Office of the US… (Sacramento, CA)
- …Civil Enforcement Unit. Responsibilities include enforcement investigations and litigation involving healthcare fraud , procurement fraud , grant fraud ... , financial fraud , pharmaceutical diversion, wildlife recovery actions, and civil rights enforcement, among other things. The selected applicant will be based in our Sacramento office and will collaborate with other Assistant US Attorneys based in both… 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
- AbbVie (Irvine, CA)
- …legal issues, including advertising, promotion, antitrust, market access, pricing, reimbursement, healthcare fraud , abuse, and anti-bribery, for both on-market ... and pipeline products. The primary focus is on international strategic priorities, and this role reports directly to the Senior Counsel for IMCO and IMAP. Key Responsibilities Include: + Serve as the strategic and legal lead counsel for pharmaceutical brands… more
- City National Bank (Los Angeles, CA)
- * FRAUD TEAM SUPPORT ANALYST* WHAT IS THE OPPORTUNITY? Responsible for analytical and project support for Fraud operations, including: conducting analysis of ... transactional data for fraud trend evaluations, queries to analyze compromises, create and...and perks we offer our colleagues including: * Comprehensive healthcare coverage, including Medical, Dental and Vision plans, available… more