- 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
- Serco (Herndon, VA)
- …in supporting eligibility processing for individuals seeking access to the Federal Healthcare Insurance Marketplace under the Centers for Medicare and Medicaid ... in Herndon, VA is seeking a highly skilled (10-12 years of experience) **Document Fraud Detection Subject Matter Expert** to join our team. This role is ideal for… more
- Humana (Dayton, 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
- 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 (Cincinnati, OH)
- …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
- General Dynamics Information Technology (Fairfax, VA)
- …**Public Trust/Other Required:** None **Job Family:** Ancillary Health **Skills:** Healthcare Fraud (Inactive),Insurance Fraud Investigations,Insurance ... Coding Subject Matter Expert (SME) supporting the Centers for Medicare and Medicaid (CMS), you will be trusted to...and Medicaid (CMS), you will be trusted to research healthcare fraud trends and draft supporting documenting… more
- Molina Healthcare (Bowling Green, KY)
- …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
- Molina Healthcare (Ann Arbor, MI)
- …The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position uses ... oral and written communication skills and presentation skills. + Medicare and Marketplace experience **JOB QUALIFICATIONS** **Required Education** High School… 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
- 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
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