Fraud, Waste & Abuse Investigations Lead
MedImpact Healthcare Systems, Inc.
A healthcare management company based in California is looking for a Fraud Investigation Manager who will be responsible for conducting thorough investigations of potential healthcare fraud and abuse. The ideal candidate must possess strong analytical skills, excellent communication capabilities, and a deep understanding of healthcare regulations. This role involves collaborating with law enforcement and developing comprehensive plans based on investigation findings. Candidates with a degree in healthcare or law are encouraged to apply. This position requires a detail-oriented approach to ensure compliance and effective fraud prevention. #J-18808-Ljbffr MedImpact Healthcare Systems, Inc.
- * Responsible for fraud and abuse detection activities for the TennCare... ...responsible for day-to-day Provider investigation-related inquiries.* Utilizes... ...allegations of fraud, waste and abuse involving... ...Ability to influence others, lead workgroups, and coordinate service...FraudContract workLocal area
- ...Responsibilities Responsible for fraud and abuse detection activities for the... ...for day‑to‑day Provider investigation-related inquiries. Utilizes... ...agencies. Cooperates with fraud, waste and abuse efforts with... ...of experience working in a lead investigative role. Proven experience...FraudContract workLocal areaMonday to FridayNight shiftWeekend work
- ...is seeking a qualified individual for a fraud detection role based in San Diego, California. The position involves investigating fraud and abuse within the defined PBA Programs, interpreting... .... Candidates should have 4-6+ years of lead investigative experience, with...Fraud
- Epwired is seeking a Global Security Investigator to conduct investigations related to fraud and Code of Conduct violations. This role involves gathering evidence, analyzing data, and collaborating with multiple teams to ensure operational integrity. Candidates should have...FraudWork experience placement
$60k - $130k
...audits, disputes, claims analysis, and investigations. Deliver high-quality,... ...and reimbursement, including potential fraud, waste, and abuse. Support the development of defensible... ...work-life balance and help employees lead fulfilling lives. Learn more about...FraudWork at officeLocal areaFlexible hours$99k - $225k
...24153 C2 Datacenter Network Architect, Lead The Opportunity: A well-designed network... ...selected will be subject to a security investigation and may need to meet eligibility requirements... ...to verify your identity and prevent fraud. Work Model Our people-first culture prioritizes...FraudFull timeContract workPart timeLocal areaRemote work- ...seeking experienced and motivated individuals for Surveillance Investigator positions. The ideal candidate will excel in problem-solving,... ...are expected to conduct thorough investigations into suspected fraud, perform mobile surveillance, and collaborate with team...FraudAfternoon shiftEarly shiftWeekday work
$99k - $225k
Overview Network Engineer, Lead The Opportunity: A well-designed network is critical... ...selected will be subject to a security investigation and may need to meet eligibility requirements... ...to verify your identity and prevent fraud. Work Model Our people-first culture prioritizes...FraudFull timeContract workPart timeWork at officeLocal areaRemote workWorldwide$99k - $225k
...requisition id: R0226901Network Engineer, Lead**The Opportunity:**A well-designed... ...selected will be subject to a security investigation and may need to meet eligibility requirements... ...authenticity and protect against identity fraud. You are expected to be on camera during...FraudFull timeContract workPart timeWork at officeLocal areaRemote workWorldwide- ...objectively evaluates and recommends improvements to SANDAG operations. OIPA is also the official body of SANDAG to investigate allegations of potential fraud, waste, abuse, and gross mismanagement identified by SANDAG staff or other stakeholders. OIPA prioritizes its efforts...FraudFor contractorsWork at officeLocal area
- ...Diego seeks a Program Coordinator for the Environmental Division. The selected candidate will oversee the Strategic Plan to Reduce Waste and implement climate action plans. Responsibilities include creating programs for waste reduction, managing compliance with regulations...
- We are continuing to build a world‑class, leading‑edge Ethics & Investigations team at Intuit. The team sits under our re‑imagined People Experience... ...Association of Workplace Investigators, Association of Certified Fraud Examiners, or other relevant organizations. Strong...FraudShift work
- Global Security Investigator , Sr Associate The Global Security (GS) team conducts investigations, protects the firm’s people and assets,... ...policies and procedures, customer safety, pre-employment screening, fraud investigations and security operations on a global basis in...FraudLocal area
- ...is seeking candidates for a GS-14 position, where you will help combat drug trafficking through planning and conducting complex investigations. This vital mission plays a significant role in national security and improves the quality of life for all Americans. Ideal...
$30 - $38 per hour
...Career in Insurance Claims with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance and Investigation... ...extensive knowledge of insurance policies and the components of fraud to determine if claims warrant reporting to the appropriate state...FraudWork at officeLocal area$45 - $52 per hour
The Materials Management Lead is responsible for overseeing daily warehouse operations, ensuring efficient material flow from receiving... ...Diego, CA. For more information, please visit . ⚠️ Recruitment Fraud Alert Recently, we have been made aware of unauthorized...FraudHourly payFull timeAfternoon shift$139.5k - $258.1k
...California, United States Software and Services Apple's iCloud Anti-Abuse team protects hundreds of millions of users from spam, phishing,... ...running at scale in production Experience with abuse detection, fraud prevention, content filtering, or trust and safety systems...FraudRelocation$85k - $95k
...policies and procedures to ensure avoidance of billing errors, fraud, waste, and abuse. Manage program billing audit procedures to ensure accuracy... ...experience in medical billing. Two years of experience leading a billing team preferred. Solid understanding of Medi-Cal insurance...FraudWork at officeFlexible hours$127.5k - $236.5k
...Job Title Lead, Program Management Job Code 38105 Job Location San Diego, CA Job Schedule... ...and performs pre‑employment substance abuse testing and background checks, where... ...employment may be subject to government security investigation(s) and must meet eligibility...Contract workFor subcontractorLocal areaFlexible hours$26 - $28 per hour
...Job Title : Lead Care Manager Program: Bridge to Care Department: Operations Reports to : Program Director FT/PT : Full-Time... ...California law and agency policy. Adhere to HIPAA, confidentiality, fraud, waste, and abuse (FWA) prevention standards. Perform other related duties as...FraudHourly payFull timeWork at officeRemote workHome office- Stout is seeking a Healthcare Compliance Manager to help healthcare organizations design, implement, and maintain compliance programs. In this role, you will oversee the rollout of compliance plans and conduct risk assessments. The ideal candidate will have a Bachelor’s...
- ...management of customer or employee accidents. Report all safety risks or issues, and illegal activity, including: robbery, theft or fraud. Adhere to all local, state and federal laws, and company guidelines. Ability to work cooperatively in high paced and...FraudSeasonal workLocal area
$45 - $55 per hour
...incidents. Report known or suspected incidents of fraud to the Administrator. Ensure that... ...training programs (e.g., OSHA, TB, HIPAA, Abuse Prevention, Safety, Infection Control, etc... ...are used in an efficient manner to avoid waste. Ensure that appropriate MSDSs are on file...FraudFull timeTraineeshipLocal areaShift work$59 - $64 per hour
...collaborative team consisting of a manager and 2–3 Senior/Lead Auditors Evaluating business processes to identify... ...preferred CPA or Certified Internal Auditor preferred Certified Fraud Examiner (CFE) or Fraud Investigation certification is a plus ...#J-18808-Ljbffr...FraudHourly payContract work$103.24k - $133.2k
...and apply your technical knowledge will help protect our nation from cyberattacks, terrorism, fraud, and evolving threats. With specialized training, real-world investigative experience, and access to cutting-edge technology, you’ll refine your clinical research and compliance...FraudWork experience placementWork at officeLocal area- ...membership. Moreover, the Medical Director, Utilization Management - leads or meaningfully contributes to the Blue Shield priorities and... ..., Clinical Subject Matter Expert for Litigation, SIU/Waste/Fraud/Abuse, Appeals/Grievances, Case Management/Population Health, Federal...FraudFull timePart timeWork at officeLocal areaWork from homeHome office2 days per week
- ...regulatory frameworks, including HIPAA and CCPA/CPRA. Provide guidance on AI laws and healthcare fraud and abuse regulations. Draft and negotiate complex legal documents. Lead projects and manage multiple deadlines with minimal supervision. Requirements Minimum of four...Fraud
$103.24k - $133.2k
...and apply your technical knowledge will help protect our nation from cyberattacks, terrorism, fraud, and evolving threats. With specialized training, real-world investigative experience, and access to cutting-edge technology, you'll refine your financial analysis and account...FraudWork at officeLocal area$69.3k - $158k
...systems Clearance Applicants selected will be subject to a security investigation and may need to meet eligibility requirements for access to... ...to ensure authenticity and protect against identity fraud. You are expected to be on camera during interviews and assessments...FraudFull timePart timeWork at officeLocal area- ...Bar Lead // Birdseye Rooftop Restaurant & Bar La Jolla, CA | Rooftop Dining Overlooking the Pacific Ocean Birdseye is a rooftop restaurant... ...bar storage areas. Monitor pars, product usage, and potential waste. Complete monthly bar inventory counts accurately and on time....Seasonal workShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Fraud, Waste & Abuse Investigations Lead. Be the first to apply!

