Fraud, Waste & Abuse Investigations Lead
Medimpact Healthcare
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
- * 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
$60k - $130k
...audits, disputes, claims analysis, and investigations. * Deliver high-quality, accurate... ...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 our...FraudWork at officeLocal areaFlexible hours$120k - $189k
...FICO (NYSE: FICO) is a leading global analytics software company, helping businesses in... ...production. Assist with client meetings to investigate and resolve problems. Apply data mining... ...by 90 of the top 100 US lenders. • Fraud Detection and Security - 4 billion...FraudWorldwide$112.9k - $257k
...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... ...and protect against identity fraud. You are expected to be on camera during...FraudFull timeContract workPart timeWork at officeLocal areaRemote work$99k - $225k
...Network Engineer, Lead The Opportunity: A well-designed network is critical to... ...selected will be subject to a security investigation and may need to meet eligibility requirements... ...and protect against identity fraud. You are expected to be on camera during...FraudFull timeContract workPart timeWork at officeLocal areaRemote workWorldwide$76 per hour
...improve efficiency and effectiveness. Manage and conduct all internal and external theft investigations, suspected unethical conduct, accidents, workplace violence, fraud, waste or abuse and ensure that activities are conducted within the framework of established...FraudFor contractorsLocal areaNight shift- ...pharmacy regulations • Maintain current knowledge of HIPAA, Fraud Waste & Abuse, and other healthcare compliance requirements • Supervise... ...standards Preferred Qualifications • Prior experience leading pharmacy operations in a retail healthcare setting • Experience...FraudLocal areaMonday to Friday
- ...Prepare and dispense appropriate pharmaceuticals to patients. Lead a team of pharmacy technicians. Manage the overall day-to... ...medications dispensed. Stay current with HIPAA and Fraud Waste and Abuse credentialing. Comply with all applicable legal rules, regulations...FraudLocal area
$129.11k - $209.06k
...Inc. is seeking an experienced Senior/Principal GeoEnvironmental Engineer to enhance our solid waste engineering practice in Southern California. This role involves leading technical projects, providing strategic client support, and spearheading business development efforts...$130k - $140k
...Preparing and dispensing appropriate pharmaceuticals to patients, leading a team of pharmacy technicians and managing the overall day... ...Keep abreast and stay current with HIPAA and Frauds Waste and Abuse credentialing Comply with all applicable legal rules,...FraudLocal areaMonday to Friday$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$127.5k
...interest of national security. Job Title: Lead, Program Management Job Code: 38105... ...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- ...Medical Officer will assign or delegate the Medical Director to lead or meaningfully contribute to Promise Health Plan priorities... ...Clinical Subject Matter Expert for Litigation SIU/Waste/Fraud/Abuse Appeals/Grievances Case Management/Population Health...FraudWork at office
- ...Services. Prepare summaries of special investigations on the occurrence of nosocomial and community... ...Report known or suspected incidents of fraud to the Administrator. Ensure that... ...are used in an efficient manner to avoid waste. Ensure that established policies governing...FraudLocal areaImmediate start
- ...Trustee (AUST), attorneys, and associated investigative, audit, and administrative staff by... ...schedules, and statements to identify fraud or abuse. Draft pleadings in cases that... ...progressively higher-level graduate education leading to such a degree; or possession of a...FraudPermanent employmentFull timePart timeInternshipWork at officeRelocationTrial period
$127.5k - $236.5k
...interest of national security. Job Title: Lead Program Manager, Resileint Maritime... ...workplace and performs pre‑employment substance abuse testing and background checks, where... ...may be subject to government security investigation(s) and must meet eligibility requirements...Contract workFor subcontractorLocal areaFlexible hours- ...policies. Report known or suspected incidents of fraud to the Administrator. Ensure departmental... ...training programs (e.g., OSHA, TB, HIPAA, Abuse Prevention, Safety, Infection Control).... ...supplies are used efficiently to avoid waste. Ensure appropriate MSDSs are on file for...FraudTraineeshipWork at officeFlexible hoursShift workWeekend work
$152.65k - $203.55k
...Arup’s Science sector in Southern California. This leader will lead the establishment of a Science hub in San Diego, support ambitious... ...veteran, or disability. Stay safe online. Recruitment fraud is on the rise, and Arup’s name, logo, and branding have been used...FraudPermanent employmentWork at officeLocal areaRemote workFlexible hours$32 - $34 per hour
...Patient Advocacy team as a Patient Advocate Lead. In this role, you have the opportunity... ...for consumers and professionals, investigating claims of client rights violations, and... ...standards Experienced in facing verbal abuse or hostile interactions from clients, family...Full timeWork at officeFlexible hours- ...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...FraudTraineeshipWork at officeShift workWeekend work
$60 - $64 per hour
...with audit team members, including managers and senior/lead auditors Communicate audit results and insights to... ...CPA) Certified Internal Auditor (CIA) Certified Fraud Examiner (CFE) or fraud investigation experience Please submit your resume in Word or...Fraud$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$84.36k - $93.24k
...and Employment Eligibility Substance Abuse Screening Physical Exam (if applicable... ...property. Position Description: Lead Estimators are responsible for the development... ...or charge, (b) in furtherance of an investigation, proceeding, hearing, or action,...For contractorsWork at officeLocal area$100k - $140k
..., reciprocating engines, and waste-to-energy projects. MasTec Industrial... ...meetings and perform site investigations as assigned ~ Become... ..., as follows: Lead Estimator Designation: When... ...enforcement agency and report fraud at . MasTec Clean Energy...FraudTemporary workWork experience placementFor subcontractorWork at officeLocal areaRemote workFlexible hours- ...Retirement Benefits with 401(k) match Leading Financial Security Benefits... ...Ashley McKinney Sr. Associate | HR Fraud Alert: We are aware of fraudulent interview... ...forward it to ****@*****.*** and we will investigate further. IT is actively investigating the...FraudInternship
$125k - $232k
...interest of national security. Job Title: Lead, Crypto-Communications Security Systems... ...and performs pre-employment substance abuse testing and background checks, where... ...employment may be subject to government security investigation(s) and must meet eligibility...Local areaFlexible hours$90k - $130k
...Consultant to join our growing Consulting team. This role supports complex engagements involving transaction-related due diligence, fraud investigations, litigation support, forensic accounting, and technical accounting analysis. The ideal candidate brings strong analytical...Fraud- ...Required Qualifications: At least one year of experience in a site lead in a customer service environment, preferably in a Human... ...pace. Obtain a favorable criminal background check and security investigation. US Citizen. Proficient in English, both written and oral....Contract workWork at officeLocal areaMonday to Friday
$67k - $110.6k
...handling of auto claims including customer contacts, coverage, investigation, evaluation, reserving, negotiation, and resolution in... ...claim files and transactions. Identify and escalate potential fraud or complex claims for further investigation. Coordinate with internal...FraudRelocation package$25 - $26 per hour
...Accessioning Lead California Office - San Diego, CA 92121 Overview Salary Range $25.00 - $26.00 Hourly Accessioning Lead... ...monitor their patients undergoing treatment for pain or substance abuse. Precision's objective is to improve patient adherence/...Hourly payFull timeWork at office
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