- Molina Healthcare (Milwaukee, WI)
- …reporting, and when appropriate, recovery of money related to health care fraud , waste, and abuse. Duties include performing accurate and reliable medical review ... Counsel, and Medical Officers in order to achieve and maintain appropriate anti- fraud oversight. **Job Duties** + Responsible for developing leads presented to the… more
- State of Colorado (Denver, CO)
- …Only: Experience Only: Ten (10) years of relevant experience in overseeing Medicaid or Medicare fraud , waste, and abuse (FWA) operations that includes work on: + ... Office of the Inspector General (OIG), the Centers for Medicare and Medicaid (CMS), US Attorney's Office, United States...education and/or relevant experience in an occupation related to healthcare fraud , waste, and abuse (FWA) operations… more
- Banner Health (AZ)
- … compliance. Experience with audit processes Knowledge of Medicare /Medicaid regulations Strong analytical and investigative skills Excellent communication ... bring your experience and skills to BPN. As a Fraud , Waste, and Abuse Specialist, you will be responsible...experience in an insurance and/or healthcare environment. Healthcare experience including AHCCCS / Medicare experience.… more
- 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
- Humana (Oklahoma City, OK)
- …Oklahoma resident** + Strong clinical experience to include multiple practice areas + Healthcare fraud investigations and auditing experience + Knowledge of ... us put health first** Humana Healthy Horizons in Oklahoma is seeking a Fraud and Waste Professional 2 who conducts investigations of allegations of fraudulent and… more
- Humana (Tallahassee, FL)
- …* A minimum of 2 years' experience conducting comprehensive health care fraud investigations (Medical Coding or Healthcare (Medical Chart Review/Insurance ... part of our caring community and help us put health first** The Fraud and Waste Professional 2 is responsible for conducting comprehensive investigations of… more
- PruittHealth (Norcross, GA)
- …them effectively to providers, potential members and key decisions makers. * Complete annual Medicare Fraud , Waste and Abuse Training and Model of Care Training ... required, with strong preference for candidates with previous experience in Medicare or healthcare sales and engagement. **MINIMUM LICENSURE/CERTIFICATION… more
- Molina Healthcare (ID)
- …operations of the Compliance Program, Compliance Plan, Code of Conduct, and Fraud , Waste and Abuse Plan across the enterprise while ensuring compliance with ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare … more
- Prime Healthcare (Ontario, CA)
- 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
- 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