- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …as assigned by management Qualifications: + Minimum of 5 years of FWA, healthcare and/or Medicare Advantage experience + Strong knowledge of Medicare ... Position Purpose: The Analyst - Fraud , Waste & Abuse (FWA) provides leadership in...a complex, high-pressure environment + Bachelor's degree in Business, Healthcare Administration or related field + High-degree of computer… 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 (Columbus, OH)
- …**Required Qualifications** + Must reside in Ohio + At least 2 years of healthcare fraud investigations and auditing experience + Knowledge of healthcare ... part of our caring community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will… more
- Humana (Montpelier, VT)
- …investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste works within specific guidelines and procedures; applies advanced ... Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with Fraud , Waste, and Abuse in either a Managed Care or… more
- Executive Office for US Attorneys and the Office of the US… (Denver, CO)
- …and analytical work to support the criminal litigation needs of Health Care Fraud (HCF) investigations and trials for the United States Attorney's Office. Typical ... work assignments will include: Providing technical litigation support to Health Care Fraud (HCF) criminal trial teams in order to facilitate litigation decisions,… more
- Elevance Health (Nashville, TN)
- …for the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds ... **Investigator II - Medicare ** **Locations:** + GA-ATLANTA, 740 W PEACHTREE ST...claims. + Responsible for identifying and developing enterprise-wide specific healthcare investigations that may impact more than one company… more
- Molina Healthcare (Nampa, ID)
- …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
- Zelis (Plano, TX)
- …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
- ICF (Baltimore, MD)
- … data systems, Medicare and Medicaid claims, and the government's healthcare fraud , waste, and abuse workflow. Job Location- Primarily remote within ... , waste, and abuse, and in support of ongoing healthcare fraud investigations by internal staff and...degree in a related field. + Demonstrated knowledge of healthcare claims data, including Medicare and Medicaid.… 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