Nurse Audit Lead - OR Compliance & Fraud Review
Elevance Health
Elevance Health is seeking a Nurse Audit Senior focused on investigating potential fraud through medical reviews. Candidates must possess a minimum of 4 years of clinical nursing experience and a current RN license in their state. The role allows for virtual work full-time but may require in-person training. Preferred qualifications include knowledge of auditing principles and OR roles, along with strong communication and negotiation skills. Elevance Health offers a supportive environment for diverse applicants. #J-18808-Ljbffr
$42.46k
...Working Title: OPERATIONS REVIEW SPECIALIST (WT: MS ANALYST I)... ...the state, the Department is leading the way to A Safer Florida through... ...assurance, monitoring, compliance, and support activities as well... ...credential issuance and reduction in fraud. Knowledge, Skills, and...FraudWork experience placementWork at officeNight shift$66.27k
...Inspector General (OIG) conducting audits, to include internal, compliance, and performance audits, and consulting... ...Internal Auditors (IIA), as well as reviews or other oversight engagements in... ...General, while being alert to potential fraud, waste, and abuse. This position...FraudFull timeWork at office- ...Fraud Analyst Job Category: Operations Full-Time On-site Kendall Description... ...risk management and regulatory compliance. Duties & Responsibilities:... ...systems. Support regulatory exams, audits, and internal reviews related to fraud risk. Participate...FraudFull timeWork at office
- The Fraud Analyst - Pibank is responsible for the timely detection, investigation... ...activities, supports regulatory compliance, and ensures accurate... ...AML, Compliance), and supporting audit and regulatory readiness. Key Responsibilities: Review and investigate fraud alerts...Fraud
- ...The Compliance and Risk Management Specialist is responsible for assisting... ...of monitoring and auditing applicable to the medical centers... ...Support in the development/review and oversight of departments'... ...exposures and reports of possible fraud, waste, and abuse....FraudWork experience placementLocal area
- Clinical Fraud Investigator II Locations: This role requires associates... .... Examines claims for compliance with relevant billing and... ...prevention and control. Review and conducts retrospective analysis... ...an Associate Degree in Nursing and/or current certification as a Certified...FraudTemporary workWork at officeLocal area2 days per week1 day per week
- ...execution, and reporting for IT audits, including SOX IT General... ...include significant operational, compliance and IT risks. Essential... ...execution of independent RAAS reviews to evaluate the design and... ...Communication: Participate in / lead meetings with Sr. Management...Full timePart timeWork experience placementInterim roleWork at officeLocal areaWork from homeRelocationMonday to Thursday
- ...(IT) Senior Auditor participates in the audit, analysis, and testing of IT controls across... ...work assignments, the supervision and review of the audit team's work, the review and... ...required by law. Determines extent of compliance with applicable law, established policies...Local area
- ...requirements, and compliance with all regulatory... ...Federal surveys. Lead or organize tracers... ...collection tools and review of data. Lead, coordinate... ...with oversight of audit tools and results... ...health care fraud and abuse and complying... ...Florida RN license or other type of healthcare...FraudFull timeLocal areaMonday to FridayShift work
- Elevance Health is looking for a Clinical Fraud Investigator II in Miami, Florida. This role involves... ...collaborating with various teams to ensure compliance and mitigate risks. Applicants should have an Associate Degree in Nursing or a Certified Professional Coder certification...Fraud
$139.2k - $293.5k
...core part of our DNA across our audit, tax, and consulting groups.... ...searching for a Senior Manager to lead projects in the areas of... ...technical analysis and quality review on tax credit studies and communicating... ...this role is 08/31/2026. In compliance with federal law, all persons...For contractorsApprenticeshipLocal areaRemote workWorldwide- ...services organization in Miami is seeking a Program Compliance & Fraud Specialist to ensure adherence to HUD regulations. This role requires reviewing applications, investigating allegations of fraud, and conducting audits to maintain program integrity. Candidates should...Fraud
- Pibank USA is seeking a Fraud Analyst in Miami, Florida. This role is responsible for... ...communication abilities. Responsibilities include reviewing fraud alerts, documenting investigations... ...with internal stakeholders to ensure compliance with policies and SLAs. #J-18808-Ljbffr...Fraud
- ...IT Lead Senior Auditor We have openings in Tallahassee, Boynton... ..., and supervising complex IT audits at State agencies, educational... ...assignments, the supervision and review of the audit team's work, the... ...by law. Determines extent of compliance with applicable law,...Local area
- ...The Director of Ethics & Compliance is responsible for developing... ...the Vice President of Internal Audit, the Director will work closely... ...global compliance, and skilled in leading teams, with a strong... ...related to ethics, misconduct, fraud, or other compliance matters...FraudWorldwideRelocationFlexible hours
- ...role, not an advisory or compliance function. Key... ...protocols across the group Lead scenario planning, pre-... ...authority, human override, and auditable escalation paths... ...the platform Structural fraud risk arising from... ...operating cadence for risk review and escalation Provide...FraudContract workWork at officeLocal areaRemote work
- ...to identify, evaluate, and manage risks impacting the organization. The role includes vetting registrations, investigating fraud, and reviewing financial documents. A Bachelor’s degree in Accounting or related field and 2-3 years of experience in risk management are preferred...Fraud
- ...Circulator - Registered Nurse 2 The University of... ...opportunity for a Specialty, OR - Circulator -... ...and physician orders. Reviews, evaluates, and reports... ...team members, ensuring compliance with all regulatory guidelines... ...system, provides leading-edge patient care powered...Part timeWorldwide
- ...understanding of accounting principles and audit procedures, as well as the capability of... ...issuance Financial statement preparation Review, train, and oversee staff progress Effectively... ...How You'll Stand Out: Ability to lead teams Bilingual in Spanish We embrace authenticity...
- ...Introduction We’re looking for a Compliance Officer who understands... ...close to the business, review real customer activity,... ...venture capital from leading fintech and crypto... ...with AML, sanctions, fraud, and trade-based money... ...internal reviews, audits, law enforcement requests...FraudContract workRemote work
- ...and well-respected internal audit team that add value to the organization... ...’ trusted controls and compliance advisor? Are you available to... ...Execution – Planning Reviews the audit objectives and risks... ...request for information (RFI). Leads the day-to-day audit...Work at office
$73.5k - $212.28k
...guidance to clients on tax planning, compliance, and strategy. These... ...our Firm. You are expected to lead with integrity and authenticity... ...Effectively mentor others. Use the review of work as an opportunity to... ...refer to specific PwC tax and audit guidance), the Firm's code of...Full timeH1b$95.5k - $195.4k
...core part of our DNA across our audit, tax, and consulting groups.... ...healthcare clients by delivering tax compliance, consulting, and strategic... ...healthcare industry. You will lead multiple client engagements,... ...Manage and oversee the review of multiple engagements. Research...Work at officeLocal areaWorldwide- ...focused on helping businesses with tax strategy, ensuring tax compliance, increasing post tax profits, and providing application support... ...industries. Responsibilities of the Tax Manager role: -Review tax returns for individuals, partnerships, and corporation -Review...
$130k - $150k
...Professional Services - Accounting & Audit Firms (CPA) Desafíos Clave... .... Resumen del Rol Join a leading Miami CPA firm in Brickell as Lead, Tax Compliance & Client Advisory. Oversee tax filings... ...Principales Oversee and review preparation of federal and state...Work at office- ...strong understanding of domestic tax compliance, with LATAM tax regulations exposure... ...: Manage the preparation and review of the company's tax provisions, ensuring... ...tax provision calculations. Tax Audits & Dispute Resolution: Lead and manage tax audits in both domestic...Local area
- ...focus in the area of internal auditing or equivalent; Must... ...Expectations and ensure team compliance Ensures compliance with established... ...; Protect against fraud and theft of the organization... ...Conduct financial analytical reviews upon request by Internal Audit...FraudFull timeShift work
$150.8k - $318k
...core part of our DNA across our audit, tax, and consulting groups.... ...structures and transactions. You will lead a team within Washington... ...' tax burdens while managing compliance risk Collaborate across... ...engagements Provide comprehensive review of work products and offer...Work at officeLocal areaWorldwide$139.2k - $293.5k
...searching for a Senior Manager to lead projects in the areas of... ...technical analysis and quality review on tax credit studies and communicating... ...role is 08/31/2026. In compliance with federal law, all persons... ...industry expertise to provide audit services to public and private...For contractorsApprenticeshipLocal areaRemote workWorldwide$100k - $120k
...Operations is responsible for leading end-to-end claims... ...benefit configuration, compliance, and performance... ...regulatory compliance, audit readiness, and risk oversight... ...Oversee payment integrity, fraud prevention, and... ...providers, leading operational reviews, governance forums, and...FraudFull timeShift work
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