Healthcare Fraud Investigator — Senior
CVS Health
CVS Health, Meritain Health’s SIU, seeks an Investigator to support the Network Cost Management team in pursuing fraud prevention and recovery across self-insured commercial plans. You will conduct investigations of known or suspected healthcare fraud and abuse, coordinate with law enforcement, and document all activities in the tracking system. Strong analytical and communication skills are essential for success. #J-18808-Ljbffr CVS Health
- The Hispanic Alliance for Career Enhancement is seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit. This role involves managing complex investigations into suspected healthcare fraud, waste, and abuse while enabling remote...SeniorRemote jobWork at office
- CVS Health is seeking a skilled investigator to assess and enhance processes preventing fraudulent healthcare claims. The role involves case analysis, documentation, and... ...with law enforcement to support prosecution of fraud and abuse, while presenting findings to stakeholders...Suggested
- Ex is searching for professionals to join their Insurance Premium Audit Team in Connecticut, United States. This role offers a competitive compensation package with targeted earnings between $50K-$70K, combining an hourly base rate and production bonus incentives. The position...SeniorRemote jobHourly payWork from home
- ...Fractal in Connecticut is seeking a Senior Healthcare Account Manager to lead strategic client relationships in the healthcare domain. This role requires a deep understanding of client needs and objectives, coupled with strong leadership skills. The ideal candidate will...Senior
- ....5 million people. As part of Hartford HealthCare's integrated nine-hospital system, Hartford... ...~ Strong institutional support for investigator-led research, quality improvement, and... ...respected Acute Care Surgery program in a senior-level capacity are encouraged to apply...SeniorWorldwide
$62.7k - $97.2k
...A healthcare organization in Hartford, Connecticut is seeking an experienced accountant to perform professional accounting work involving analysis, preparation of journal entries, and financial statements. The ideal candidate should have at least 5 years of accounting...SeniorWork at office$78.9k - $147.5k
A leading healthcare organization is seeking a senior pharmacist specializing in program management to oversee specialty pharmacy initiatives. The successful candidate will manage clinical programs and serve as a consultative resource, bringing together interdisciplinary...Senior- The Hispanic Alliance for Career Enhancement is seeking a Senior Manager, Product Manager for Aetna's Cost Estimator Tool. This role... ...transparency initiatives that enhance members' understanding of healthcare costs and decision-making. The ideal candidate will have extensive...Senior
- A leading healthcare solutions company is seeking experienced Technical Business Analysts to optimize clinical workflows and data exchange processes. Ideal candidates will have extensive experience in healthcare data, strong analytical capabilities, and the ability to...SeniorRemote work
- Datavant is seeking a Senior Strategic Engagement Lead to enhance customer relationships in healthcare technology. This role involves managing a key account portfolio and ensuring customer satisfaction through impactful engagement strategies. The ideal candidate will have...Senior
$76.52k - $163.9k
...seeking a Sr. Practice Solutions Relationship Manager to manage client relationships and provide tailored financial solutions for healthcare professionals. Requirements include a bachelor’s degree or equivalent experience, 7 years in Practice Finance sales, and advanced...Senior$101.7k - $155.9k
Munich Reinsurance America, Inc is seeking a Senior Claims Specialist to manage healthcare-related claims, including file handling and strategic partnerships with counsel and vendors. The role demands over 7 years of experience in specialty claims and the ability to work...Senior$120k - $160k
A biotechnology firm in Hartford, Connecticut is seeking a Senior Virology Care Specialist to build strong relationships across healthcare providers. The role involves facilitating clinical dialogues and driving product demand, requiring over 5 years of sales experience...Senior- IMCS Group is seeking a Senior Consultant in Healthcare to join our Hartford, CT team. You will gather and analyze healthcare business requirements, support data analysis, and collaborate with cross-functional teams in an Agile Scrum environment to deliver healthcare technology...Senior
- Sonara Inc. is seeking a Remote Senior Consultant specializing in Healthcare. The role primarily focuses on business analysis within the SRQ domain, requiring strong collaboration with cross-functional teams in an Agile Scrum environment. Candidates should have 8-10 years...SeniorRemote job
- ...an Advanced Lung Disease (ALD) Specialist to increase sales of products, focusing on fostering relationships within the targeted healthcare community. The role involves managing a specific territory and requires strong sales acumen, along with clinical expertise in pulmonology...SeniorRemote job
- ...will solve complex problems using data and provide insights to senior executives. The ideal candidate will have a Bachelor's Degree,... ...extensive experience in data analysis, and the ability to work with healthcare data. This role includes management responsibilities, leading a...Senior
$113k - $132k
Cognizant is seeking a Senior Facets Configuration Analyst to support the configuration and validation of the Facets core claims platform for healthcare. In this remote role, you will configure components, validate outcomes, troubleshoot issues, and document approaches...SeniorRemote job$46.99k - $122.4k
CVS Health is seeking a dedicated individual to contribute to a team-oriented environment where you will be working on healthcare plans and benefit administration. The ideal candidate should have experience in Meritain Plan Build and a strong understanding of medical terminology...SeniorFull time- Molina Healthcare, located in Hartford, Connecticut, is seeking to provide senior level support for health plan growth and community engagement activities. You will be responsible for achieving enrollment and referral growth objectives, collaborating with various departments...Senior
$106k - $149.33k
...analytics. The position offers a range of responsibilities including developing predictive models and visualizing data to support healthcare strategy. Compensation ranges from $105,997 to $149,328 per year, with benefits including medical coverage, retirement savings,...SeniorRemote job$94.9k - $130.5k
A healthcare company seeks a Digital Product Owner to lead Agile teams in delivering exceptional digital experiences in the Medicare sector. You will manage the product backlog and collaborate with engineering and design teams to meet user needs. This role demands 5+ years...SeniorRemote job- ...in Information Technology and strong expertise in Java/J2EE technologies. Candidates with analytical skills and experience in the healthcare domain will excel. This position involves collaborating with diverse stakeholders and requires familiarity with Agile and...Senior
- Owens & Minor, a global healthcare solutions company, seeks a Sr. Pricing & Deal Desk Analyst to support pricing strategy, RFP processes, and contract execution. You will collaborate with Finance, Sales, Marketing, and National Accounts to drive compliant, market-based...SeniorContract work
- ...issues, and enhancing the implementation process for optimal customer satisfaction. The ideal candidate should have 3-5 years of healthcare industry experience, project management skills, and proficiency in Microsoft tools. This position offers full-time hours with a comprehensive...SeniorFull time
- A leading healthcare solutions provider seeks a Senior Upgrade Engineer in Hartford, Connecticut. This position involves performing upgrades on Medical Informatics products, providing technical support, and ensuring customer satisfaction. Candidates must have an associate...SeniorRemote job
- JPS Tech Solutions is seeking a highly capable Salesforce Consultant to join our Production Support Team for a large healthcare platform in the United States. The role focuses on Health Cloud, production support operations, and complex integrations with healthcare microservices...Senior
- Infinite Medical P.C. seeks a Laser Phototherapy Technician to support its dermatology division across multiple healthcare facilities. You will operate and maintain laser equipment, prep patients, and monitor them during and after treatments while following strict safety...SeniorAfternoon shift
- ...Come build something with Shepley Bulfinch as a Senior Healthcare Project Manager! Shepley Bulfinch is seeking a well‑rounded Senior Healthcare Project Manager who is creative and passionate about architecture, curious about solving complex problems, and looking to grow...SeniorFor contractorsFlexible hours
$23.16 - $35.88 per hour
A healthcare organization is seeking a Claims Analyst to review and process Stop Loss claims, managing client relationships and ensuring compliance with organizational standards. Candidates should have at least 5 years of relevant experience in health insurance claims,...SeniorHourly pay
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