- Centene Corporation (Frankfort, KY)
- …a subject matter expert for the Contractor's Program Integrity unit to reduce Fraud , Waste and Abuse of Medicaid services within Kentucky. Provides direction and ... guidance to staff who investigate and remediate compliance and fraud , waste, and abuse related matters; while maintaining an investigative workload of moderate to… more
- Publicis Groupe (Irving, TX)
- …degree in Business, Computer Science, Engineering, or a related field. **Qualifications** ** FRAUD DETECTION** * Experience with Fraud Analytics or Investigations ... requirements, and designing up process flows. * Understands what fraud typologies and industry best practices are in ...fraud typologies and industry best practices are in fraud prevention, detection and remediation spaces * Able to… more
- MyFlorida (Tampa, FL)
- …Analyst position is in the Office of the Attorney General within the Medicaid Fraud Control Unit in Tampa, Florida or Orlando Florida, and involves auditing complex ... multi-million-dollar healthcare fraud investigations that can result in criminal and/or civil...as lead investigator on cases involving suspected Cost Report Fraud and Prospective Payment System Medicaid provider fraud… more
- CVS Health (Phoenix, AZ)
- …Lead Director, Service Operations, this position will focus on utilization, quality and fraud waste and abuse review for individual cases for members across Aetna . ... appropriate in matters pertaining to the investigation of suspected healthcare fraud cases Completion of Fraud waste and abuse reviews in partnership with SIU. +… more
- Concentrix (Arnold, MO)
- …or conceptual thinking. + Servicing both Debit/Credit Card and Debit/Credit Card Fraud Calls. Servicing active debit/credit card accounts including calls related to ... programs or repricing. Origination of new accounts. Debit/Credit Card Fraud , addressing members report of unauthorized activity on their...calls from members who have filed a credit card fraud claim and have follow-up questions or calling to… more
- Mastercard (Harrison, NY)
- …payments. Role: Lead strategic initiatives to enhance issuer performance, strengthen fraud prevention, and deliver exceptional customer experiences across the NAM ... Franchise. This role combines deep expertise in issuer card operations and fraud detection with strong leadership and collaboration skills to drive measurable… more
- Louisiana Department of State Civil Service (LA)
- …Crimes, Violent Crime and Drug Unit, Sexual Predator Apprehension Team, and the Insurance Fraud Unit. The Criminal Division also serves: + Medicaid Fraud Control ... the responsibility to investigate and prosecute all types of fraud perpetrated by providers of medical services in the...Criminal + Federalism + Gaming + Litigation + Medicaid Fraud Control + Public Protection + No Preference Required… more
- MTA (Jamaica, NY)
- …with the COSO framework relative to risk assessment, internal controls and fraud prevention as well as marketing, training and communication of the program ... Law Section 2931-2923 to promote effective and efficient operations while rooting out fraud , waste and abuse. Serve as a leading advisor in managing MTA and… more
- New York State Civil Service (Schenectady, NY)
- …Coordinates all phases of the investigation and referral of suspected criminal tax fraud case to ensure a successful prosecution:-In cooperation with the audit and ... techniques.-Assists in the development of statewide projects to detect criminal tax fraud .-Assists in the development of statewide projects to detect criminal tax … more
- TD Bank (New York, NY)
- …or documentation related to these areas + Leads capacity analysis for Fraud software to determine appropriate staffing levels + Collects and analyzes pertinent ... information and data pertaining to fraud committed against TD Bank + Conducts detailed statistical...against TD Bank + Conducts detailed statistical analysis involving fraud loss and check card data and correlate to… more