• Investigator, Special Investigative Unit - FLORIDA

    Molina Healthcare (Syracuse, NY)
    …reporting, and when appropriate, recovery of money related to health care fraud , waste, and abuse. Duties include performing accurate and reliable medical review ... Counsel, and Medical Officers in order to achieve and maintain appropriate anti- fraud oversight. **Job Duties** + Responsible for developing leads presented to the… more
    Molina Healthcare (09/22/25)
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  • Senior Counsel

    University of Rochester (Brighton, NY)
    …assisted living communities. This includes, but is not limited to fraud and abuse, billing compliance, corporate transactions, physician employment and compensation, ... researches, analyzes, and provides regulatory compliance advice on the Fraud and Abuse + Laws, including, but not limited...the False Claims Act, Civil Monetary Penalties, and + Medicare and Medicaid billing regulations (including CMS, Medicare… more
    University of Rochester (09/25/25)
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  • Medical Investigator I/II (RN Required)

    Excellus BlueCross BlueShield (Rochester, NY)
    …this position is responsible for the accurate and thorough clinical investigation of potential fraud , waste and abuse (FWA) for all lines of business. The scope of ... + Prepares recommendations on preventive/corrective measures for the deterrent of future fraud . + Supports other SIU investigators and analysts with their cases by… more
    Excellus BlueCross BlueShield (09/17/25)
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  • Compliance Analyst II, Urmc and Affiliates

    University of Rochester (Rochester, NY)
    …compliance with Medicare , Medicaid, and third-party payer billing regulations, and fraud , waste, and abuse prevention. + Serves as a resource and subject matter ... conducts investigations, risk assessments, and regulatory monitoring to prevent and detect fraud , waste, and abuse, specifically addressing the DRA, NY SSL | 363-d,… more
    University of Rochester (10/03/25)
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  • Clinical Investigator

    MVP Health Care (Rochester, NY)
    …Anti- Fraud investigation and reporting requirements including HIPAA, CMS, Medicare , Medicaid, and any corporate compliance initiatives or policies. + Minimal ... York State Nursing license required (RN preferred). Experience in health insurance fraud investigations preferred. + Obtain CPC and/or COC credential. + Maintain… more
    MVP Health Care (09/20/25)
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  • The State University of New York - Senior Counsel…

    New York State Civil Service (Albany, NY)
    …will include providing legal services related to healthcare compliance, complex healthcare transactions, matters involving state and federal fraud and abuse ... will serve as the primary attorney for the OGC in providing comprehensive healthcare legal services and guidance to the State University and its State-operated… more
    New York State Civil Service (08/09/25)
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