- Humana (Albany, NY)
- …part of our caring community and help us put health first** The Senior Fraud and Waste Professional conducts investigations of allegations of fraudulent and ... abusive practices. The Senior Fraud and Waste Professional work assignments involve moderately complex to complex issues where the analysis of situations or data… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Senior Fraud and Waste Professional (Program Integrity Lead) is responsible for overseeing the ... monitoring and enforcement of the Fraud , Waste , and Abuse (FWA) program. This role aims to prevent and detect potential FWA activities in accordance with state… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and ... abusive practices. The Fraud and Waste Professional 2 work assignments are varied and frequently require interpretation and independent determination of the… more
- Humana (Albany, NY)
- …part of our caring community and help us put health first** The Manager, Fraud and Waste Investigator : Nurse Audit/Review performs clinical audit/validation ... and determines approach, resources, schedules and goals. The Manager, Fraud and Waste Investigator : Nurse Audit/Review validates and interprets medical… more
- Molina Healthcare (Syracuse, NY)
- …ASSOCIATION** : + Health Care Anti- Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all ... investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste , and abuse. Duties include performing accurate and reliable… more
- Highmark Health (Albany, NY)
- …Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider ... for conducting investigations of organizational or functional activities related to alleged fraud , waste and abuse perpetrated by providers, members, facilities,… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …this position is responsible for the accurate and thorough clinical investigation of potential fraud , waste and abuse (FWA) for all lines of business. The scope ... + Prepares recommendations on preventive/corrective measures for the deterrent of future fraud . + Supports other SIU investigators and analysts with their cases by… more
- City of New York (New York, NY)
- …of clean drinking water for New Yorkers. DOI is seeking a Confidential Investigator who will be responsible for investigating fraud , corruption, and ... will be responsible for the investigation of matters involving fraud , waste and abuse related to the...of Management & Budget approval for budgeted headcount. CONFIDENTIAL INVESTIGATOR - 31143 Qualifications 1. A four-year high school… more
- City of New York (New York, NY)
- …Construction (DDC), and Department of Parks and Recreation (DPR), seeks an experienced investigator to serve as an Assistant Inspector General. Squad 10 oversees a ... Inspector General (AIG) who will lead and conduct criminal investigations into fraud and corruption relating to City agencies, employees and contractors. This… more
- City of New York (New York, NY)
- …environment, where analytical rigor, data fluency, and critical thinking are vital to uncovering waste , fraud , and abuse. As a Data Analyst, you will manage and ... enhance practices for identifying patterns and trends related to fraud , waste and abuse. - Assist with...of Management & Budget approval for budgeted headcount. CONFIDENTIAL INVESTIGATOR - 31143 Qualifications 1. A four-year high school… more