- Molina Healthcare (Tampa, FL)
- …for compliance by overseeing, follow-up and resolution of investigations . **Knowledge/Skills/Abilities** * Assists with implementation and day-to-day operations ... of the Compliance Program, Compliance Plan, Code of Conduct, and Fraud , Waste and Abuse Plan across the enterprise while ensuring compliance with governmental… more
- CVS Health (Tallahassee, FL)
- …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 ...federal, state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud . +… more
- Highmark Health (Tallahassee, FL)
- …including auditing/monitoring operational processes, conducting or overseeing compliance investigations , and ensuring that adequate training takes place under ... and external audit progress, recurring risk and compliance reporting, mandated training, investigations , and the impacts of new and changing laws, regulations, and… more
- Zelis (St. Petersburg, FL)
- …We do not use WhatsApp or personal emails for recruitment. Forward any suspected fraud to ###@zelis.com for prompt investigation . Thank you for staying vigilant. ... with providers + Experience and working knowledge of Health Insurance, Medicare guidelines and various healthcare programs + Understanding of hospital coding… more
- Zelis (St. Petersburg, FL)
- …We do not use WhatsApp or personal emails for recruitment. Forward any suspected fraud to ###@zelis.com for prompt investigation . Thank you for staying vigilant. ... revenue opportunities + Experience and working knowledge of Health Insurance, Medicare guidelines and various healthcare programs + Strong understanding of hospital… more