- Somatus (Mclean, VA)
- …to enhance contract and member performance. + Use analytics to identify healthcare cost trends and drivers. + Partner with **teams** to evaluate initiatives ... + **Payment Integrity Product Areas:** Clinical Claim Review, Payment Analytics, Fraud Capture, Utilization Review **Product Management** + **Build** business cases… more
- Otsuka America Pharmaceutical Inc. (Richmond, VA)
- …paired with the best-in-class delivery mechanism needed for today's healthcare professionals, caregivers, and patients. Key Responsibilities Include: + **Strategy ... contacting Accommodation Request ([email protected]) . **Statement Regarding Job Recruiting Fraud Scams** At Otsuka we take security and protection of… more
- Carrington (Richmond, VA)
- …regulatory requirements, and investor/agency/product specific guidelines. Also, ensure that all fraud red flags are identified and fully investigated, and findings ... exception/dispute review and audit rebuttal process. * Complete default servicing fraud investigations and suspicious activity reviews as well as provide… more
- Otsuka America Pharmaceutical Inc. (Richmond, VA)
- **Company Background/Culture** Otsuka is a global healthcare company with the corporate philosophy: "Otsuka people creating new products for better health ... contacting Accommodation Request ([email protected]) . **Statement Regarding Job Recruiting Fraud Scams** At Otsuka we take security and protection of… more
- Otsuka America Pharmaceutical Inc. (Richmond, VA)
- **Position Summary** The Director, HCP Marketing Lead guides the healthcare provider (HCP) engagement strategy for Centanafadine, a novel launch product for ADHD. ... contacting Accommodation Request ([email protected]) . **Statement Regarding Job Recruiting Fraud Scams** At Otsuka we take security and protection of… more
- CVS Health (Richmond, VA)
- …Director, Aetna Medicaid, this role is responsible for utilization, quality, and fraud , waste, and abuse reviews for individual cases involving members across Aetna. ... specializing in neurodiversity, including quality assurance and issues related to fraud , waste, and abuse. **Required Qualifications:** * A minimum of five… more
- Baylor Scott & White Health (Richmond, VA)
- …individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core ... Auditor to join our Internal Audit team in the healthcare sector. This role is critical in operational efficiency,... Internal Audit Professional (CHIAP) - AHIA * Certified Fraud Examiner (CFE) - ACFE **Belonging Statement** We believe… more
- DXC Technology (Ashburn, VA)
- …must be open to traveling up to 50% for client meetings. + **Consumer & Retail, Healthcare & Life Sciences:** Candidates must be in NJ, NY, PA, MA, Seattle, WA or ... generation, and deal closures in the **Consumer & Retail, Healthcare & Life Sciences & Cross Industry Solutions (CIS)**...to requests for accommodations due to a disability. Recruitment fraud is a scheme in which fictitious job opportunities… more
- RELX INC (Alexandria, VA)
- …performance? About our Team Elsevier is singularly focused on helping healthcare and health education professionals improve clinical outcomes through evidence-based ... Us A global leader in information and analytics, we help researchers and healthcare professionals advance science and improve health outcomes for the benefit of… more
- Humana (Richmond, VA)
- …identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our financial recovery. The Senior Payment Integrity Professional ... an impact** **Required Qualifications** + Bachelor's degree in Business, Finance, Healthcare Administration, Data Analytics, or a related field, or equivalent work… more
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