- CVS Health (Albany, NY)
- …this role, you will manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + ... Conduct high level, complex investigations of known or suspected acts of healthcare fraud , waste and abuse . + Conduct Investigations to prevent payment of… more
- Highmark Health (Albany, NY)
- …3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations **Preferred** + 1 year in Financial Analysis ... + Certified Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of… more
- KPH Healthcare Services, Inc. (Gouverneur, NY)
- …drug screening test **Required Training:** + HIPPA Privacy Course + HIPPA Security Course + Fraud , Waste, and Abuse Course + MethGuard Course + HIPPA Privacy CE ... Mastery Exam + HIPPA Security CE Mastery Exam + Fraud , Waste, and Abuse CE Mastery Exam...as relevant skills, years of experience and education. KPH Healthcare Services, Inc. is a multistate organization and abides… more
- KPH Healthcare Services, Inc. (Syracuse, NY)
- …drug screening test **Required Training:** + HIPPA Privacy Course + HIPPA Security Course + Fraud , Waste, and Abuse Course + MethGuard Course + HIPPA Privacy CE ... Mastery Exam + HIPPA Security CE Mastery Exam + Fraud , Waste, and Abuse CE Mastery Exam...such as relevant skills, years of experience,and education. **KPH Healthcare Services, Inc. is a multistate organization and abides… more
- Amazon (New York, NY)
- …- 5+ years of legal experience - Healthcare regulatory experience, eg fraud waste and abuse laws, telehealth regulations, direct primary care, value-based ... Description We are looking for a talented healthcare transactions counsel to help reinvent primary care for customers. This role supports the strategic growth… more
- Molina Healthcare (Buffalo, NY)
- …SIU an active relationship with third parties who have specific experience in conducting fraud and abuse investigations. * Prepares written reports to inform the ... Enforces, as a representative of management, the Compliance Plan, Code of Conduct and Anti- Fraud Plan. * Establishes, at the direction of the AVP of Compliance or… more
- Molina Healthcare (Yonkers, NY)
- …standards and requirements contained in the Molina Medical Compliance and Fraud , Waste and Abuse Program. **KNOWLEDGE/SKILLS/ABILITIES** + Coordinates, conducts, ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare … more
- Molina Healthcare (Rochester, NY)
- …day-to-day operations of the Compliance Program, Compliance Plan, Code of Conduct, and Fraud , Waste and Abuse Plan across the enterprise while ensuring ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare … more
- MVP Health Care (Schenectady, NY)
- …metrics such as recovery rates, audit turnaround times, and dispute resolution outcomes. ** Fraud , Waste & Abuse (FWA) Prevention** + Lead FWA detection efforts ... CPC (Certified Professional Coder), CCS (Certified Coding Specialist), CFE (Certified Fraud Examiner), CHFP (Certified Healthcare Financial Professional), Lean… more
- Amentum (Albany, NY)
- …and assets. + Analyze large and complex healthcare claims datasets to identify fraud , waste, and abuse patterns. + Design and run SQL queries, models, and ... data analytics. + Support development of internal best practices and workflows for healthcare fraud detection. **Required Qualifications:** + Must be able to… more