- Citizens (Pittsburgh, PA)
- …regulations and standards. Qualifications: + Experience: Extensive experience in either fraud detection management, fraud investigations , strategy or ... Description Job Title: Senior Fraud Operations Manager - OLB and...OLB and Mobile Fraud Detection Description: Citizens Fraud & Claims Organization is seeking a… more
- Citizens (Glen Allen, VA)
- Description The Manager of Fraud Risk Oversight will support the independent Risk Oversight of the Fraud and Claims divisions and all aspects of Fraud ... including the effectiveness of Fraud Strategy/Analytics, the efficiency of Fraud Alert Review and Investigations and effectiveness of Front-Line Controls… more
- USAA (Phoenix, AZ)
- …in identifying potential fraud . Responsible for operational management of Claims fraud investigative teams. Directs staff in the advanced identification ... strong and proven leader to manage our SIU (Special Investigations Unit) Analytics and Digital Fraud Detection...+ Extensive knowledge and experience in all levels of claims investigation or fraud investigation and regulatory… more
- Humana (Montpelier, VT)
- …a part of our caring community and help us put health first** The Special Investigations Unit Manager leads and monitors investigations of allegations of ... fraudulent and abusive practices. The Manager , Fraud and Waste works within specific...schedules and goals. **Where you Come In** The Special Investigations Unit Manager assists coordinating investigation with… more
- State of Colorado (Denver, CO)
- …embezzlement of patient trust funds). This position may also be assigned to civil investigations in support of the Colorado False Claims Act. Additionally, the ... Medicaid Fraud Investigator (Special Agent III) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5057010) Apply Medicaid Fraud Investigator… more
- Bank of America (Richmond, VA)
- …space. + Collaboration: Collaborate with various departments, including compliance, fraud investigations , and operations, to ensure effective coordination ... a relevant field + Advanced SAS/SQL coding ability + Fraud and/or Claims background + Understanding of...offered a role with Bank of America, your hiring manager will provide you with information on the in-office… more
- Ankura (Chicago, IL)
- …to Life Sciences clients and external counsel through compliance, disputes, investigations and advisory services. The position has tremendous growth potential with ... be working with practice leadership to provide exemplary compliance, disputes, investigations and litigation support (eg, expert witness) services across the Life… more
- Capital One (Richmond, VA)
- …to include Fraud Strategy and Prevention, Fraud Investigations , Claims and Disputes. **The Senior Manager supports the line of business by:** + ... Senior Manager , Compliance Advisor - Retail Bank The Senior Manager , Compliance Advisor - Retail Bank performs a key risk management role (second line of… more
- Centene Corporation (Indianapolis, IN)
- …program integrity and disclosure requirements. Develop, implement and manage strategic fraud , waste and abuse activities by maintaining state and federal ... Medicaid product lines. + Safeguard against the potential for fraud , waste and abuse and coordinate with, the Special..., waste and abuse and coordinate with, the Special Investigations Unit and state agencies to promptly investigate reports… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …FWA investigations and audits; or five years of insurance claims investigation experience or professional investigation experience with law enforcement agencies; ... for the accurate and thorough clinical investigation of potential fraud , waste and abuse (FWA) for all lines of...and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. +… more
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