• Manager , Fraud and Waste

    Humana (Boston, MA)
    … leads and monitors investigations of allegations of fraudulent and abusive practices. The Manager , Fraud and Waste works within specific guidelines and ... goals. **Where you Come In** The Special Investigations Unit Manager assists coordinating investigation with law enforcement authorities. Leads...Medicare experience + Minimum 3 years of experience with Fraud , Waste , and Abuse in either a… more
    Humana (09/24/25)
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  • Director, Bureau of Program Integrity

    State of Massachusetts (Boston, MA)
    …and property. The OIG is an independent state agency charged with preventing and detecting fraud , waste , and abuse in the use of public funds and public ... Services (EOHHS) and works to detect, correct and prevent fraud , waste and abuse in public benefits...agencies. The ideal candidate for Director is a strong manager and effective communicator with experience related to public… more
    State of Massachusetts (09/23/25)
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  • Manager , CIC Advanced Practice Clinician…

    Commonwealth Care Alliance (Boston, MA)
    …and Procedures + Promptly, and in good faith, reports an instances of suspected fraud , waste and abuse; suspected privacy and/or security incidents; or any ... require intensive care management and care delivery. Within the CIC Program, the Manager , Clinical APC is responsible for the oversight of clinical care delivery and… more
    Commonwealth Care Alliance (08/19/25)
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  • Professional Auditor

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …assessed levels of risk. Identifies potential quality of care issues and potential fraud , waste , or abuse. Makes referrals for follow-up as necessary. Actively ... regarding coding and billing. The Professional Auditor, under the direction of Audit manager , will collaborate with a variety of business units including Fraud … more
    Blue Cross Blue Shield of Massachusetts (09/22/25)
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  • Community Health Worker

    Commonwealth Care Alliance (Boston, MA)
    …policies and procedures + Promptly, in good faith, report any instances of suspected fraud , waste , or abuse; suspected privacy and/or security incidents; or any ... and/or the Doula Program. The CHW reports to the Community Health Services Manager . **Supervision Exercised:** * No, this position does not have direct reports.… more
    Commonwealth Care Alliance (08/27/25)
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  • Medication Authorization and Access Supervisor

    Beth Israel Lahey Health (Boston, MA)
    …members work to ensure information accuracy. (essential) 9. Monitors situations for fraud , waste , and abuse of Medicare/Medicaid benefits and reinforces HIPAA ... difference in people's lives.** This individual will report to the Med Auth and Access Manager and will be responsible for the supervision of the med auth and access… more
    Beth Israel Lahey Health (09/22/25)
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