- CVS Health (Harrisburg, PA)
- …plan sponsor. The lead reviewer is accountable for the validation of existing fraud waste and abuse business rules and leads designed to detect aberrant billing ... Aetna business. + Keep current with new and emerging fraud , waste, and abuse schemes and trends through training...3-5 years of data interpretation and analysis experience. + Healthcare background. + Experience with internal claims data and… more
- CVS Health (Hartford, CT)
- …actuarial analysis to assess the financial risks and implications of healthcare programs, insurance products, and benefit plan designs. + Completes financial ... forecasting and projection analysis to estimate future healthcare costs, revenue, and profitability. + Analyzes claims data to assess patterns, trends, and cost… more
- CVS Health (Springfield, IL)
- …medical codes for diagnoses as documented for physicians and other qualified healthcare providers in the office and/or facility setting. + Thorough knowledge of ... opportunities for providers, vendors and peers. + Expertise in medical documentation, fraud , abuse and penalties for documentation and coding violations based on… more
- Micron Technology, Inc. (San Jose, CA)
- …enabling team members to select the plans that best meet their family healthcare needs and budget. Micron also provides benefit programs that help protect your ... AI to fabricate or misrepresent qualifications will result in immediate disqualification. Fraud alert: Micron advises job seekers to be cautious of unsolicited job… more
- Micron Technology, Inc. (Boise, ID)
- …enabling team members to select the plans that best meet their family healthcare needs and budget. Micron also provides benefit programs that help protect your ... AI to fabricate or misrepresent qualifications will result in immediate disqualification. Fraud alert: Micron advises job seekers to be cautious of unsolicited job… more
- CVS Health (Columbus, OH)
- …communication skills + Advanced experience in Excel **Preferred Qualifications** + Experience in healthcare fraud , waste and abuse + Knowledge of Medicaid ... We are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a...skills in SQL and Python who can transform complex healthcare data into actionable insights to support fraud… more
- RELX INC (New York, NY)
- …Team: A global leader in information and analytics, we help researchers and healthcare professionals advance science and improve health outcomes for the benefit of ... and research, health education and interactive learning, as well as exceptional healthcare and clinical practice. At Elsevier, your work contributes to the world's… more
- CVS Health (Baton Rouge, LA)
- …Director, Aetna Medicaid, this role is responsible for utilization, quality, and fraud , waste, and abuse reviews for individual cases involving members across Aetna. ... specializing in neurodiversity, including quality assurance and issues related to fraud , waste, and abuse. **Required Qualifications:** * A minimum of five… more
- Zelis (St. Petersburg, FL)
- …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 ... top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across… more
- Micron Technology, Inc. (Boise, ID)
- …and 3 years of experience in the job offered or in a business analyst or process analyst -related occupation. Position requires: 1. Driving planning for new ... enabling team members to select the plans that best meet their family healthcare needs and budget. Micron also provides benefit programs that help protect your… more