- CVS Health (Hartford, CT)
- …each and every day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU). ... you will manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + Conduct high level,… more
- Molina Healthcare (Idaho Falls, ID)
- …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
- State of Colorado (Denver, CO)
- …A combination of related education and/or relevant experience in an occupation related to healthcare fraud , waste, and abuse (FWA) operations that is equal to ... Fraud Waste and Abuse Division Director Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5033338) Apply Fraud Waste and Abuse Division… more
- Humana (Oklahoma City, OK)
- …**Required Qualifications** + **Must be an Oklahoma resident** + 2+ years of healthcare fraud investigations and auditing experience + Knowledge of healthcare ... help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the Oklahoma Medicaid Team. This team of… more
- Elevance Health (Norfolk, VA)
- …Coding Certificate or Registered Nurse strongly preferred + Law Enforcement dealing with Healthcare Fraud Please be advised that Elevance Health only accepts ... **Clinical Fraud Investigator II** **Location** : _Hybrid1:_ This role...and medical records prior to payment. + Researches new healthcare related questions as necessary to aid in investigations.… more
- State of Georgia (Fulton County, GA)
- …or more items below: + Attorneys with civil litigation experience, with an emphasis on healthcare or fraud matters. + Demonstrated ability to work in a team is ... Assistant Attorney General- Medicaid Fraud Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/67792/other-jobs-matching/location-only) Hot… more
- Humana (Oklahoma City, OK)
- …Oklahoma resident** + Strong clinical experience to include multiple practice areas + Healthcare fraud investigations and auditing experience + Knowledge of ... us put health first** Humana Healthy Horizons in Oklahoma is seeking a Fraud and Waste Professional 2 who conducts investigations of allegations of fraudulent and… more
- Zelis (St. Petersburg, FL)
- …prevention, investigations, or risk management - preferably in payments, fintech, or healthcare . + Proven expertise in fraud detection tools, behavioral ... So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more… more
- CVS Health (Hartford, CT)
- …and local law enforcement agencies to ensure compliance and support the prosecution of healthcare fraud and abuse matters. + Demonstrate a high level of ... proceedings. + Deliver presentations to internal and external stakeholders regarding healthcare fraud matters and the organization's approach to combating… more
- CVS Health (Charleston, WV)
- …investigators and analysts to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to ... a team in the planning and execution of investigations of acts of healthcare fraud and abuse by both members and providers. Provides direction and counsel on… more