- Molina Healthcare (Macon, GA)
- …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
- State of Georgia (Fulton County, GA)
- …Medicaid Program. Participates as a member of an interdisciplinary team in Healthcare fraud investigations , and provides support to members of other disciplines ... of providers as requested. + Assists prosecutors in Healthcare Fraud investigations by reviewing provider and patient...claims and/or claims data; experience in the detection and investigation of healthcare fraud . Additional Information +… more
- CVS Health (Atlanta, GA)
- …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 (Atlanta, GA)
- …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