Clinical Fraud Investigator II: Healthcare Risk & Compliance
Elevance Health
Elevance Health, based in Florida, seeks a Clinical Fraud Investigator II to identify potential fraud and abuse risks. The role supports hybrid work with in-office presence 1-2 days per week, and alternate locations may be considered for commuting candidates. Responsibilities include data analysis, in-depth investigations, and reviewing claims before payment to prevent fraud. Collaboration with the Special Investigation Unit is required. #J-18808-Ljbffr Elevance Health
- ...Clinical Fraud Investigator II Locations: This role requires associates to be... ...entities that may pose potential risk associated with fraud and... .... Examines claims for compliance with relevant billing and... .... Researches new healthcare related questions as necessary...SuggestedTemporary workWork at officeLocal area2 days per week1 day per week
- ...Job Summary: The Enterprise Fraud Analyst is responsible for identifying, investigating, and mitigating fraud risks across Educational Federal Credit Union’s entire enterprise... ...enterprise risk management and regulatory compliance We encourage you to view and apply...SuggestedFull timeWork at office
- ...Our Deloitte Regulatory, Risk & Forensic team helps client... ...Senior Consultant, Forensics and Investigations,on the project, you will: Work... ...regulations and practices or fraud detectionAbility to perform job... ...8 Job ID 364198 Risk, Compliance, and Governance | Forensics...SuggestedLocal area
- ...all the requirements. The Enterprise Fraud Analyst is responsible for identifying, investigating, and mitigating fraud risks across Educational Federal Credit Union's... ...enterprise risk management and regulatory compliance We encourage you to view and apply directly...SuggestedWork at officeImmediate start
- ...Miami, FL, is expanding into the clinical research field. Our mission... ...join our team as a Principal Investigator in our clinical research... ...participants, and ensure regulatory compliance across multiple therapeutic... ...(PI) on upcoming Phase II–III clinical trials . Review...SuggestedRemote workFlexible hours
- ...DescriptionJOB SUMMARYLeverages banking, fraud, investigative, and financial crimes expertise to... ...financial institution partners, BSA/AML, Compliance, Human Resources, Legal, and other... ...priorities simultaneously, make complex risk-based decisions with limited information...Full time
- ...Oncology Clinical Researcher (AI Training) About the Role What if your deep expertise in cancer clinical trials could directly... ...outputs related to study protocols, patient enrollment, and compliance standards Analyze and validate AI-generated interpretations...Hourly payOngoing contractContract workFreelanceRemote workFlexible hours
- ...Job Description Job Description Healthcare Fraud Investigator Employment Type: Full-Time, Mid-Level Department: Litigation Support... ...qualifications: - Relevant Healthcare Fraud experience including compliance, auditing duties, and other duties in Section 3. -...Full timeWork experience placementWork at officeLocal area
- ...to delivering high-quality Phase I-IV clinical trial execution to help sponsors bring... ...off to recharge. : The Principal Investigator ensures adherence to protocol requirements... ...in the regulations. Ensure Protocol Compliance Possess a thorough understanding of...Full timeContract workReliefWork at officeImmediate startNight shift
- ...SummaryThe Senior Finance Intelligence Analyst, Clinical Service Line serves as the primary... ...year, and established benchmarks; investigates and explains variances.Develops benchmarking... ..., Economics, Business Administration, Healthcare Administration, or a related field is...Full timeShift work
$20 per hour
...an OPS Medical Health Care Program Analyst to support fraud and abuse prevention within the Medicaid Program Integrity unit. The role involves investigations, audits, and on-site visits to ensure policy compliance and identify overpayments. The position covers 1-15% travel...Hourly payFull time- Evolution Research Group (ERG) is seeking a Principal Investigator for CPMI-Clinical Pharmacology Miami. The PI ensures protocol adherence, protects subjects' rights, and upholds FDA and GCP standards across site activities. The role includes supervising Sub-Investigators...
- Evolution Research Group (ERG) is seeking a Sub-Investigator to serve as the secondary physician at the clinical site, supporting the Principal Investigator and... ...role emphasizes adherence to GCP/ICH, protocol compliance, and regulatory documentation, with responsibilities...
- ...assistance Job Summary: The SIU Field Investigator is responsible for investigating the facts surrounding insurance fraud claims across Dade and Broward Counties for... ..., and detailed investigative reports in compliance with state regulations and company standards...Local areaRemote workFlexible hoursAfternoon shift
- ...appropriate and professional mannerMaintain the confidentiality of the organization's clientsActively work to identify and minimize risk on projects and proposalsDraft letters, documents requests, and reports for review by ManagersProvide timely and consistent updates...Work experience placement
- ...Fraud and Security Assistant This position can be located at... ...and Responsibilities: Investigate, review and analyze cases of... ...fraud, examining data to ensure compliance with internal Policies and Procedures... ..., legal, ethical and Bank risk mitigation requirements...Bank staffWork at office
- Job Description Job Description LOOKING FOR EXPERIENCE MOBILE PARAMEDICAL EXAMINERS IN DADE, BROWARD, PALM BEACH COUNTIES. WE ARE A AFFILIATE OF EXAMONE/QUEST DIAGNOSTIC. WE PROVIDE EXAMS FOR THE LIFE INSURANCE INDUSTRY AND FOR QUEST AT HOME CLIENTS. THE EXAMINER...
- ...security of guests and associates. This role requires expertise in safety operations and the ability to identify and manage potential risks effectively. Ideal candidates are experienced, detail-oriented, and able to maintain calm in pressure situations. The position plays...
- ...Governance, Risk & Compliance (GRC) Analyst (AI Training) About the Role We're partnering with the world's leading AI research labs to build smarter, more reliable AI systems - and we need practitioners who know how GRC actually works in the real world. If you...Hourly payOngoing contractContract workFreelanceRemote workFlexible hours
- An excellent opportunity for a Principal Investigator/ Medical Director to join Quotient Sciences - Miami, a dedicated, state-of-the-art, clinical pharmacology facility. The Miami site specializes in phase I clinical pharmacology studies with a proven track record of almost...Interim roleNight shiftDay shift
- BioTalent seeks Nurse Practitioners for a Sub-Investigator role to support Phase I-IV trials across neuroscience, psychiatry, neurology... ...Investigator, perform study visits and evaluations, ensure GCP/ICH compliance, monitor safety, lead the informed consent process, and...Full time
$33.5 - $38.5 per hour
A reputable insurance firm is seeking a Premium Insurance Field Auditor in Miami, FL. The role requires conducting audits for insured businesses, analyzing financial records, and preparing detailed reports. Candidates should possess strong communication skills and the ability...Remote jobHourly payFor contractors$25 - $30 per hour
...Description Command Investigations, LLC is looking for Surveillance Investigators to become part of a dynamic team. This is a great opportunity for individuals with prior investigative experience who demonstrate integrity, independence, and a drive to succeed in a fast...Hourly pay16 hoursFull timeWork at officeRemote workFlexible hoursShift workNight shiftWeekend work$100k - $150k
...Sub-Investigator/ Nurse Practitioner Miami, FL | On-site Full-Time Help Advance Life-Changing Clinical Research Great opportunity for Nurse Practitioners interested in... ...for research participants ✔ Ensure compliance with study protocols, GCP, ICH guidelines...Full timeWork at officeRelocationVisa sponsorshipFree visaNight shift$350k - $380k
...Clinical Research Physician / Principal Investigator Full-Time | On-Site | Relocation Assistance Available Join a Leading Clinical Research Organization... ...participants Ensure patient safety and protocol compliance Collaborate with sponsors, CROs, and research...Full timeRelocation package$25.37 - $30.7 per hour
Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties...- ...Criminal Investigator This vacancy is for a GS-1811-9/11, Criminal Investigator located in the Department of Homeland Security, U.S. Coast Guard, COAST GUARD INVESTIGATIVE SERVICE -CG-CGIS. This is a re-announcement to Job Announcement Number 26-13026448-HQ-EP-DE....
- ...locker rooms inspectionsPatrol of all areas of the hotel. Monitor life and safety systems to include fire panels, cameras.Perform investigations as needed.Responds to police officials in the building, to include fire department.Any other assignments by management....Work at officeLocal areaImmediate startAll shiftsShift workNight shift
- ...confidentiality of all Security/Loss Prevention and property reports/documents; release information only to authorized individuals. Conduct investigations and gather evidence. Conduct interviews with relevant parties.Follow all company policies and procedures; report accidents,...Work experience placementShift work
- ...confidentiality of all Security/Loss Prevention and property reports/documents; release information only to authorized individuals. Conduct investigations and gather evidence. Conduct interviews with relevant parties. Follow all company policies and procedures; report accidents,...Full timeWork experience placementRemote workShift work
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