- Molina Healthcare (Boise, ID)
- …insurance company + Minimum of two (2) years' experience working on healthcare fraud related investigations/reviews + Proven investigatory skill; ability to ... Certification, Association + Valid driver's license required. **Preferred Experience** + Healthcare Anti- Fraud Associate (HCAFA), Accredited Health Care Fraud… more
- Molina Healthcare (Boise, ID)
- …The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position uses ... of experience working in a FWA / SIU or Fraud investigations + Thorough knowledge of PC based software...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- CVS Health (Boise, ID)
- …in the United States. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna ... you will manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + Conduct high level,… more
- Idaho Division of Human Resources (Boise, ID)
- …at least 5 years of investigative experience, preferably in law enforcement, healthcare fraud or financial crimes. Strong analytical; interviewing, and ... minimum of 5 years of investigative experience, preferably in Medicaid or healthcare fraud , financial crimes or white-collar investigations. + Experience… more
- CVS Health (Boise, ID)
- …3-5 years. + Strong analytical and investigative skills, with experience in healthcare fraud detection. + Proficiency in interpreting claims data, medical ... Aetna International plays a pivotal role in safeguarding the organization against fraud , waste, abuse (FWA), and compliance violations. This position is embedded… more
- Molina Healthcare (Boise, ID)
- **JOB DESCRIPTION** **Job Summary** The Molina Healthcare Internship Program shares an objective to create a stepping stone for students who aim to be professionals ... and future leaders in the healthcare business profession. Interns are assigned special projects and...include: + Economics/Finance + Data Analysis / Science + Fraud , Waste, and Abuse (FWA) + Other data intensive… more
- Molina Healthcare (Idaho Falls, ID)
- …coordinating data extractions, gathering requirements, supporting payment integrity teams, primarily fraud , waste and abuse. + Experience working on SQL, PowerBI, ... databricks. + Experience on ETL , healthcare specifically claims is highly preferred. **JOB QUALIFICATIONS** **Required Education** Associate degree or equivalent… more
- Highmark Health (Boise, ID)
- …Analytics will work closely with Senior Data Scientists to support Highmark's Fraud , Waste, and Abuse identification efforts. Daily responsibilities will involve the ... in-depth analysis of complex healthcare claims data utilizing advanced analytical techniques to detect...the business. - Collaborate with senior team members on Fraud , Waste, and Abuse identification initiatives to develop and… more
- Otsuka America Pharmaceutical Inc. (Boise, ID)
- Otsuka America Pharmaceutical Inc. is a global healthcare company with the corporate philosophy: "Otsuka-people creating new products for better health worldwide." ... In its evolved customer engagement model, a Neuroscience Specialist engages healthcare providers (HCPs) using in-person, virtual, and digital tools, offering… more
- Otsuka America Pharmaceutical Inc. (Boise, ID)
- …factors influencing US market access, including reimbursement trends, payer concerns and healthcare policy + Strong understanding of the US payer environment, payer ... market dynamics, payer marketing principles and how healthcare players make decisions across private & public channels + Proven track record of developing and… more