• Senior Specialist, Delegation Oversight (Remote)

    Molina Healthcare (Dallas, TX)
    …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 (08/21/25)
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  • Medicare Compliance Manager (Medicare Advantage…

    Molina Healthcare (Houston, TX)
    …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
    Molina Healthcare (07/25/25)
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  • Clinical Psychologist

    CVS Health (Austin, TX)
    …to the investigation of suspected healthcare fraud cases. Completion of Fraud waste and abuse reviews in partnership with SIU + Provide SME support ... position will focus on utilization, quality, and review of fraud , waste, and abuse for individual Aetna...quality, and review of fraud , waste, and abuse for individual Aetna member cases. **Expectations/Responsibilities:** + Review… more
    CVS Health (08/08/25)
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  • Analyst, Special Investagative Unit

    CVS Health (Austin, TX)
    …extraction and analysis. The lead reviewer is accountable for the validation of existing Fraud Waste and Abuse Business Rules and leads designed to detect ... warranted. **Fundamental Components:** -Research and ad hoc report development to identify fraud , waste, and abuse schemes and trends. -Review company clinical… more
    CVS Health (08/14/25)
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  • Clinical Provider Auditor II

    Elevance Health (Houston, TX)
    …responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse . **How you will make an Impact:** + Examines ... relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. +...next step in the claims lifecycle. + Researches new healthcare related questions as necessary to aid in investigations… more
    Elevance Health (08/26/25)
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  • Clinical Provider Auditor II

    Elevance Health (Grand Prairie, TX)
    …responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse . **How you will make an impact:** + Examines ... relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. +...next step in the claims lifecycle. + Researches new healthcare related questions as necessary to aid in investigations… more
    Elevance Health (08/13/25)
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  • Assistant General Counsel - Specialty…

    Cardinal Health (Austin, TX)
    …firm or in-house healthcare experience preferred, including commercial transactions and fraud and abuse compliance expertise + Experience working with Group ... to pharmaceutical distribution and services and group purchasing organizations, specifically AKS/ Fraud & Abuse + Identify opportunities for process improvements… more
    Cardinal Health (08/02/25)
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  • Senior Cyber Forensic Investigator, Hybrid

    Experian (Allen, TX)
    …around the world. We help to redefine lending practices, uncover and prevent fraud , simplify healthcare , create marketing solutions, and gain deeper insights ... into cyber incidents, data breaches, malware infections, unauthorized access, insider threats, fraud and abuse , and employee misconduct. + Analyze digital… more
    Experian (08/02/25)
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  • Program Director, Compliance Operations…

    Texas Health Resources (Arlington, TX)
    …in areas vulnerable to error or noncompliance such as billing, coding, Stark laws, fraud & abuse laws, false claims, or other identified risk areas. Participate ... needed. 0% What You Need: **Education** Master's Degree Master?s degree in healthcare , business, or another applicable field. Req **Experience** 5 Years Minimum of… more
    Texas Health Resources (08/27/25)
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  • Assistant General Counsel - At-Home Solutions

    Cardinal Health (Austin, TX)
    …patients and prescribers and by federal and state government programs, for example, fraud and abuse (Anti-Kickback Statute, False Claims Act, Civil Monetary ... Health is seeking a driven and skilled attorney with expertise in healthcare regulatory compliance, including third party billing and reimbursement. The Assistant… more
    Cardinal Health (08/16/25)
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