- CVS Health (Harrisburg, PA)
- …conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse , to recover lost funds, ... state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters. - Demonstrates high level of knowledge… more
- Centene Corporation (Sacramento, CA)
- …fresh perspective on workplace flexibility. **Position Purpose:** Investigate allegations of potential healthcare fraud and abuse activity. Assist in ... claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse . + Conduct investigations of potential waste,… more
- CareFirst (Baltimore, MD)
- …+ Independently or as lead in part of an assigned team develop and conduct healthcare fraud , waste, and abuse investigations of all levels (low to ... of which must be health care specific and includes independently conducting healthcare fraud , waste, and abuse investigations of all levels. **Knowledge,… more
- CVS Health (Hartford, CT)
- …investigations to effectively pursue the prevention, detection, investigation and prosecution of healthcare fraud , waste, and abuse . Also reports suspected ... **Fundamental Components:** - Conducts investigations of known or suspected acts of healthcare fraud , waste, and abuse - Communicates with federal, state,… more
- CVS Health (Harrisburg, PA)
- …this role, you will 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 to prevent payment of… more
- Highmark Health (Pittsburgh, PA)
- …create reports, graphs, and charts to timely identify trends and patterns of potential healthcare fraud , waste and abuse . Communicate findings to company ... provider relations, reimbursement etc. + Calculate overpayments in established fraud , waste or abuse cases. Identify all...7 years of in the Health Insurance industry and/or Healthcare Fraud investigations + 3 years in… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …proposes new methods of data analytics and healthcare informatics to discover Fraud , Waste and Abuse activities as well as provide program-wide trend ... Healthcare Administration, Statistics, or a related field) preferred. + Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI),… more
- AbbVie (Florham Park, NJ)
- …legal issues, including advertising, promotion, antitrust, market access, pricing, reimbursement, healthcare fraud , abuse , and anti-bribery, for both ... on-market and pipeline products. The primary focus is on international strategic priorities, and this role reports directly to the Senior Counsel for IMCO and IMAP. Key Responsibilities Include: + Serve as the strategic and legal lead counsel for… more
- WellSpan Health (York, PA)
- …legal advice related to, the full range of healthcare laws, including healthcare fraud and abuse laws, hospital/physician issues, complex contract ... Education:** + Doctor of Law (JD) Required **Work Experience:** + 10+ years Healthcare law experience required + Corporate law experience required + In-house counsel… more
- Amgen (IL)
- …+ Experience counseling clients on complex legal and regulatory considerations including: + Healthcare fraud and abuse matters + FDA promotional regulations ... on price concession strategies and risk mitigation with members of the healthcare community, with emphasis on the Anti-Kickback Statute and applicable antitrust laws… more
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