- 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
- LA Care Health Plan (Los Angeles, CA)
- …or Related Field Experience Required: At least 7 years of experience in healthcare compliance, fraud investigations, law enforcement, or related field. At least ... Preferred And/Or any of the following Licenses/ Certifications: Certified Fraud Examiner (CFE) Certified HealthCare Compliance (CHC) Certified… more
- Molina Healthcare (Covington, KY)
- …insurance company + Minimum of two (2) years' experience working on healthcare fraud related investigations/reviews + Proven investigatory skill; ability to ... data, medical records, and billing data from all types of healthcare providers that bill Medicaid/ Medicare /Marketplace. **KNOWLEDGE/SKILLS/ABILITIES** + Ensure… more
- Community Hospital Corporation (Greenville, TX)
- Hunt Regional Healthcare , a leading independent Hospital District anchored by a 187-bed medical center in Greenville, Texas, is seeking an experienced and strategic ... healthcare executive to assume the role of Chief Financial...performance of managed care contracts. + Administration of all Medicare & Medicaid Reimbursement issues, including the completion and… more
- Prime Healthcare (Dallas, TX)
- Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360 ... nearly 57,000 employees and physicians. Eighteen of the Prime Healthcare hospitals are members of the Prime Healthcare...the Antikickback Statute, the False Claims Act, and other Fraud , Waste and Abuse laws and regulations, along with… more
- GE HealthCare (Boston, MA)
- …provides legal leadership and strategic legal advice related to GE HealthCare research, product development and collaboration activities. Acting as a strategic ... segment and technology teams on legal issues related to GE HealthCare sponsored and investigator-initiated research and collaboration proposals and engagements.… more
- Grant Thornton (Atlanta, GA)
- …for business and IT process optimization, profit improvement, cost reduction, fraud prevention, internal control, and compliance. + Perform engagement management ... 4 years of direct experience with diverse life sciences companies or healthcare providers, including hospitals, academic medical centers, healthcare systems, and… more
- KPH Healthcare Services, Inc. (Oklahoma City, OK)
- …plans and any changes that possibly may occur within the Insurance Payor, Medicare , or Medicaid + Responsible for completing all mandatory and regulatory training ... the specific position **Required Training:** + HIPPA Privacy & Security Course + Fraud , Waste, and Abuse Course **Job Skills Required:** + Exceptional attention to… more
- Atlantic Health System (Morristown, NJ)
- …(iv) accountable care organization compliance; (v) Medicare C & D/ Medicare Advantage compliance program requirements; (vi) Federal healthcare program ... compliance risk areas: (i) general compliance and compliance program effectiveness; (ii) fraud , waste and abuse and Deficit Reduction Act of 2005 workforce member… more
- University of Rochester (Brighton, NY)
- …assisted living communities. This includes, but is not limited to fraud and abuse, billing compliance, corporate transactions, physician employment and compensation, ... researches, analyzes, and provides regulatory compliance advice on the Fraud and Abuse + Laws, including, but not limited...the False Claims Act, Civil Monetary Penalties, and + Medicare and Medicaid billing regulations (including CMS, Medicare… more