- New York State Civil Service (Hauppauge, NY)
- …the unit's forensic accountants/auditors, detectives, and analysts to identify and prosecute financial fraud in the healthcare industry and abuse and neglect of ... Attorney General, Office of the Title Attorney: Prosecute Medicaid Fraud /Nursing Home Abuse (3836) Occupational Category Legal Salary Grade...residents in healthcare facilities, present evidence to grand juries, and conduct… more
- Centene Corporation (Columbus, OH)
- …CA, HI, IL, NE, and OH.** **Position Purpose:** Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and ... executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse. + Conduct investigations of potential waste,… more
- MyFlorida (Tallahassee, FL)
- …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator; Certified ... is to ensure fewer budgeted dollars are lost to fraud , abuse, and waste. The Bureau of Medicaid Program...(MPI) does this specifically through audits and investigations of healthcare providers, including managed care plans. This OPS Government… more
- MyFlorida (Tallahassee, FL)
- …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator; Certified ... Medical Health Care Program Analyst position will support the fraud and abuse prevention efforts within the Bureau of...responsible for developing novel methods and technologies to fight fraud , abuse, and waste. To do this, these highly… more
- Centene Corporation (Frankfort, KY)
- …for the Bachelors Degree . 5+ years of management experience Investigations and healthcare fraud -related investigations with audit and risk analysis. 1+ year of ... 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… more
- MyFlorida (Tampa, FL)
- …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... Fraud and Prospective Payment System Medicaid provider fraud involving: 1) Nursing Homes, 2) Hospitals, and 3)… more
- CVS Health (Phoenix, AZ)
- …Managers, and Directors as appropriate in matters pertaining to the investigation of suspected healthcare fraud cases Completion of Fraud waste and abuse ... Lead Director, Service Operations, this position will focus on utilization, quality and fraud waste and abuse review for individual cases for members across Aetna .… more
- Genentech (South San Francisco, CA)
- …includes the following: + Providing advice, education, training and legal direction on, healthcare fraud and abuse laws, pricing, FDA labeling and promotional ... **The Position** Genentech's Healthcare Law Group (HLG) seeks a Senior Corporate...regulations, the False Claims Act, and laws related to fraud and abuse in the life science/biotech/pharma industries. +… more
- Elevance Health (St. Louis, MO)
- …for the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds ... background. **Preferred Qualifications:** + Candidate Must Reside in Missouri + Healthcare experience strongly preferred + Fraud certification from CFE,… more
- MyFlorida (Tallahassee, FL)
- …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator; Certified ... (MPI). MPI is the Agency's lead unit responsible for oversight of Medicaid fraud , waste, and abuse, and ensure compliance with applicable laws, rules, and… more