- CVS Health (Austin, TX)
- …state, and local law enforcement agencies to ensure compliance and support the prosecution of healthcare fraud and abuse matters. + Demonstrate a high level ... **Education** + A Bachelors degree or three years of experience in healthcare fraud , waste, and abuse investigations and audits. **Anticipated Weekly Hours**… more
- CVS Health (Austin, TX)
- …of investigators and analysts to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse , to recover lost funds, and ... Leads a team in the planning and execution of investigations of acts of healthcare fraud and abuse by both members and providers. Provides direction and… more
- USAA (San Antonio, TX)
- …Supplement claim processing, operations, or administrative experience. + 5 or more years healthcare fraud , waste, and abuse investigation and/or audit ... appropriate.As a Mid-Level Life SIU Investigator for **Medicare Supplement Fraud , Waste, and Abuse ** you will support...experience. + Advanced knowledge of healthcare benefit structures within the health insurance industry, Medicare… more
- Danaher Corporation (Austin, TX)
- … industry + Drafting, reviewing, and negotiating various types of agreements + US healthcare fraud and abuse laws, rules, regulations, regulatory guidance, ... various legal issues and associated risks, including transactions with healthcare providers, research institutions, and promotional programs. + Provide… more
- Molina Healthcare (San Antonio, TX)
- …investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste, and abuse . Duties include performing accurate and reliable ... for developing leads presented to the SIU to assess and determine whether potential fraud , waste, or abuse is corroborated by evidence. + Conducts both… more
- Humana (Austin, TX)
- …3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with Fraud , Waste, and Abuse in a Managed Care setting + Minimum 3 years of ... investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste works within specific guidelines and procedures; applies advanced… more
- Danaher Corporation (Austin, TX)
- …would be a plus if you also possess previous experience in: + Experience with healthcare regulation, including: fraud and abuse (eg, anti-kickback); FDA for ... we've been dedicated to advancing and optimizing the laboratory to move science and healthcare forward. Join a team where you can be heard, be supported, and always… more
- Molina Healthcare (Houston, TX)
- …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
- Prime Healthcare (Dallas, TX)
- …to the Stark Law, the Antikickback Statute, the False Claims Act, and other Fraud , Waste and Abuse laws and regulations, along with the Medicare/Medicaid ... Overview Prime Healthcare is an award-winning health system headquartered in...an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360… more
- Prime Therapeutics (Austin, TX)
- …**Job Description** Responsible for the intake and initial handling of allegations of fraud , waste or abuse . Conducts preliminary investigation to assess the ... audit or investigation. Serves as a corporate resource on fraud , waste and abuse issues and maintains...to find suspicious patterns and outliers using knowledge of healthcare coding conventions, fraud schemes, and general… more