- CVS Health (Trenton, NJ)
- …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
- CVS Health (Trenton, NJ)
- …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
- Highmark Health (Trenton, NJ)
- …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
- Atlantic Health System (Morristown, NJ)
- …compliance risk areas: (i) general compliance and compliance program effectiveness; (ii) fraud , waste and abuse and Deficit Reduction Act of 2005 workforce member ... Medicare C & D/Medicare Advantage compliance program requirements; (vi) Federal healthcare program compliance; and (vii) other assigned risk areas identified through… more
- Sanofi Group (Morristown, NJ)
- …and wide-ranging legal matters, particularly in the area of advertising and promotion, fraud and abuse and other applicable healthcare laws. **About Sanofi:** ... to identify potential legal issues (focusing on promotional matters, regulatory issues and fraud and abuse) as well as proposed solutions to mitigate risk is… more
- The Cigna Group (Morris Plains, NJ)
- Evernorth seeks an experienced, strategic, healthcare attorney to join the legal team supporting its sophisticated specialty and home delivery pharmacies, as well as ... business leaders. The qualified candidate will have a minimum of 7-10 years' healthcare regulatory or transactional experience with a reputable law firm or in-house… more
- Otsuka America Pharmaceutical Inc. (Trenton, NJ)
- …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
- Zelis (NJ)
- …So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more ... top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across… more
- Zelis (NJ)
- …So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more ... top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across… more
- Zelis (NJ)
- …So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more ... top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across… more