- Molina Healthcare (St. Petersburg, FL)
- …Areas of exposure may include: + Economics/Finance + Data Analysis / Science + Fraud , Waste, and Abuse (FWA) + Other data intensive areas **Preferred ... **JOB DESCRIPTION** **Job Summary** The Molina Healthcare Internship Program shares an objective to create...aim to be professionals and future leaders in the healthcare business profession. Interns are assigned special projects and… more
- MyFlorida (Miami, FL)
- …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator; Certified ... an understanding about legal proceedings and investigations related to health care fraud and abuse . The Florida Medicaid program is one of the five largest in… more
- Molina Healthcare (Miami, FL)
- …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… more
- Highmark Health (Tallahassee, FL)
- …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… more
- Centene Corporation (Tallahassee, FL)
- …& tools to explore financial performance trends and/or reconciling financial data preferred. ** Fraud , Waste & Abuse :** Experience in fraud /waste/ abuse ... outcomes. + Interpret and analyze data from multiple sources including healthcare provider, member/patient, and third-party data. + Support execution of large-scale… more
- Stryker (Fort Lauderdale, FL)
- …sale and marketing of medical devices/technologies including matters related to anti-trust, fraud and abuse , HIPAA, and anti-kickback (including applicable safe ... work experience required + 3+ years applicable experience required **Preferred** + 2+ fraud and abuse , anti-kickback experience is highly desirable + Direct work… more
- CVS Health (Tallahassee, FL)
- …self-funded plan sponsor. The lead reviewer is accountable for the validation of existing fraud waste and abuse business rules and leads designed to detect ... Aetna business. + Keep current with new and emerging fraud , waste, and abuse schemes and trends...3-5 years of data interpretation and analysis experience. + Healthcare background. + Experience with internal claims data and… more
- MyFlorida (Gainesville, FL)
- …and other agencies, such as law enforcement, DCF Adult Protective Services, Medicaid Fraud Unit, and the Agency for Healthcare Administration. Maintains and ... the Photographic Wound Documentation form. + Ensure the Florida Abuse Hotline is contacted if abuse , neglect,...the Florida Abuse Hotline is contacted if abuse , neglect, exploitation, mishandling, mistreatment or sexual abuse… more
- CVS Health (Tallahassee, FL)
- …3-5 years. + Strong analytical and investigative skills, with experience in healthcare fraud detection. + Proficiency in interpreting claims data, medical ... plays a pivotal role in safeguarding the organization against fraud , waste, abuse (FWA), and compliance violations. This position is embedded within… more
- Northwest Florida Community Hospital (Chipley, FL)
- …arson, crimes against nature involving children, taking indecent liberties with children, abuse and neglect of children, failure to secure medical attention for an ... offenses, crimes against the person, crimes against property, crimes involving fraud , crimes involving health and safety, crimes involving morals and decency,… more