Hybrid Data Analytics Manager - Fraud, Waste & Abuse
Georgia
The Georgia Department of Community Health is seeking a qualified Data Analytics Manager to oversee data reporting and analysis for fraud prevention in Medicaid. This role involves managing a team and maintaining the CMO dashboard as part of a hybrid work environment. The ideal candidate will possess a Bachelor's degree in operations management or a related field, with significant experience in management. Strong leadership and collaboration skills are essential to succeed in this important position. #J-18808-Ljbffr Georgia
- Data Analytics Manager The Georgia Department of Community Health (DCH) is currently seeking qualified... ...helps safeguard the agency from fraud, waste, and abuse. The selected candidate will be... ...onsite utilization reviews. This is a hybrid position that requires in-office and...FraudInternshipWork at officeRemote work
- ...the Assistant Director, Case Intake & Data Analytics. Assign data requests received from... ...processes to proactively identify fraud, waste, and abuse. Track and monitor performance metrics... ...assigned tasks. Maintain the Case Management Organization (CMO) dashboard and participate...FraudWork at office
$30.5k - $43.5k
.... We identify and prevent fraud, waste, and abuse so individuals can access... ...innovative technology and powerful data analytics, we help government and... ...and motivated Case Management Assistant (Onsite). This role... ...is a plus. Expectations Hybrid work arrangement based in...FraudFull timeWork at officeMonday to FridayFlexible hours2 days per week- ...seeking a Clinical Provider Auditor II in Atlanta, Georgia. This hybrid role requires 1‑2 days a week in the office, promoting... ...will be responsible for identifying potential risks related to fraud and abuse through examination and analysis of claims. Minimum qualifications...FraudWork at office2 days per week1 day per week
- Oscar Health Insurance is looking for a Manager, Data Analytics to join their Operations Team in Atlanta, GA. This role is hybrid, requiring 3 days in-office work weekly. Key responsibilities include analyzing data issues, collaborating with various teams, and driving analytical...SuggestedWork at office
- ...Member Service Hybrid Agent (Sandy Springs) The Hybrid Member Service Agent... ...strong organizational and time management skills. Educate members on emerging... ..., counterfeit currency, elder abuse, check kiting, account takeover fraud, new account fraud, wire fraud and...FraudWork at officeFlexible hours
$86.3k - $118.7k
...Within this position the Dental Fraud and Waste Lead for the Humana Dental... ...associated with fraud, waste and abuse cases, as well as perform... ...and guidance to creating new data tools to review provider outliers... ...of recruiters and hiring managers an enhanced method for decision...FraudFull timeTemporary workFor contractorsRemote workWork from homeHome officeMonday to Friday$86.3k - $118.7k
Humana Inc in Atlanta, Georgia is seeking an experienced Dentist for a remote position with the Dental Fraud and Waste Team. The role involves conducting clinical reviews related to fraud and providing education to a team of dental investigators. The ideal candidate must...FraudRemote job- The Georgia Department of Community Health is seeking a qualified individual for a managerial role focused on data analytics. Responsibilities include leading data request assignments, approving outputs, and ensuring compliance with Medicaid policies. Applicants should...Fraud
$31.77 per hour
...Tobin is hiring for a Call Center representative in Atlanta, GA, offering a hybrid work model with 3 days onsite after training. The role involves managing inbound calls related to Risk and Fraud, requiring a minimum of 2 years experience in risk management or financial...Fraud- ...seeking a Lead Client Services Program Manager to organize and lead project teams... ...programs and delivering high-quality analytics services for fraud detection and compliance. Ideal candidates... ...compliance. This position offers a hybrid working model with a focus on...FraudRemote job
- ...role involves investigating assigned cases, analyzing claim data to detect fraud, and drafting investigation reports. Ideal candidates will have... ...related investigation or audit roles. The position offers a hybrid work model, requiring in-office attendance 1-2 days per week...FraudWork at office2 days per week1 day per week
- ...Analyst/Associate for Transaction Fraud Analytics in Atlanta, GA. The ideal... ...models, monitor transaction data, and conduct root cause... ...fraud analytics. The role is hybrid, working closely with IT, Information... ...to strengthen the fraud management processes. #J-18808-Ljbffr...Fraud
- US032 Victor Insurance Managers LLC is hiring a Manager, Metrics - Analytics and Reporting in Atlanta, GA. This full-time role involves leading a team of data analysts and engaging with leadership to provide data-driven insights for strategic decisions. The ideal candidate...Full timeRemote workFlexible hours
- ...which helps safeguard the agency from fraud, waste, and abuse. The selected candidate will serve as direct report to the Data Analytics Manager. The Compliance Specialist 3 will be responsible... ...for onsite investigations. This is a hybrid position that requires in‑office and...FraudWork at officeRemote work
$23.7 - $39.1 per hour
Credentialing Analyst, Infusion Clinics/Nursing Hybrid: This role requires associates to be... ...for health plans and pharmacy benefit managers (PBM) for all pharmacy sites. How you... ...during accreditation renewals. Fraud, Waste and Abuse annual attestation submission to...FraudHourly payWork at officeLocal area2 days per week1 day per week$92.5k - $120k
...application of controls to effectively manage risks. This position will provide hybrid/remote flexibility, though... ...compliance assessments Risk data analytics and controls automation Forensic... ...with forensic reviews (fraud/waste/abuse) What you can expect from us: Our...FraudWork experience placementWork at officeLocal areaRemote work- ...Arnex Solutions LLC is seeking a SAO Data Conversion Analyst (Workday) to join their team in Atlanta, GA. This hybrid role focuses on developing and executing data conversion... ...environment with opportunities for troubleshooting and project management. #J-18808-Ljbffr...
$126.3k - $173.7k
...focused Lead Product Manager to drive... ...accuracy, reduce waste, and optimize compliance... ...rule engines, analytics, and automation tools... ...to identify fraud, waste, and abuse (FWA) Ensure solutions... ...environments Data & Value... ...To ensure Home or Hybrid Home/Office employees...FraudFull timeTemporary workWork at officeRemote workWork from homeHome office$60k
...passion for accuracy, compliance, and fraud prevention. Role: Medicare Claims Examiner... ...documentation Investigate fraud, waste, and abuse (FWA) concerns and support payment integrity... ...High attention to detail, analytical thinking, and accuracy in a high-volume...FraudPermanent employment$60k
...passion for accuracy, compliance, and fraud prevention. Role Details Title: Medicare... ...additional documentation Investigate fraud, waste, and abuse (FWA) concerns and support payment... ...discrepancies High attention to detail, analytical thinking, and accuracy in a high-volume...FraudPermanent employmentLocal area- ...medical records related to claims. The consultant will work on fraud, waste, and abuse issues while collaborating with healthcare regulators. The... ...experience, at least 3 years in healthcare, and strong analytical and communication skills. This role involves site...Fraud
- ...and addressing potential losses from fraud, waste, or abuse, evaluating the effectiveness of internal... ..., analyzes, and appraises evidentiary data as a base for an informed, objective... ...maintains productive relationships with management; effectively makes oral presentations...FraudCasual workFlexible hours
- ...support recurring budget forecasts and identify potential fraud, waste and abuse based on procurement history and purchase trends; and, Procurement... ...correspondence to a variety of customers such as inventory management specialists, other service line contacts, and contracting...FraudContract workRemote workMonday to Friday
$67.64k - $101.46k
Elevance Health is seeking an Investigator II in Atlanta, Georgia, to lead investigations into healthcare fraud. The role combines in-office collaboration 1-2 days a week with remote flexibility. Responsibilities include conducting claim reviews, developing investigations...FraudWork at officeRemote work2 days per week1 day per week- ...Power Co is seeking a Safety & Health Specialist to manage and interpret safety data to ensure regulatory compliance. The ideal... ...safety analysis. This corporate role follows a hybrid schedule and involves 85% analytical tasks alongside direct field responsibilities. The...
$127.77k
...Regions, the Digital Product Manager leads the discovery, development... ...such as usage, sales, fraud, and other key information to... ...meaningful research and propose data-driven ideas to close customer... ...hands on expertise with Adobe Analytics, including report suites, segmentation...FraudFull timeWork at officeRelocationVisa sponsorshipWork visaRelocation packageFlexible hours3 days per week$111.03k - $145.73k
Oscar is looking for a Manager, Data Analytics to join the Operations Team in Atlanta, GA. This hybrid role requires you to work on-site 3 days a week, focusing on solving complex data issues in the healthcare industry. Key duties include collaborating with various teams...3 days per week- .... Report known or suspected incidents of fraud to the Administrator. Attend and participate... ...as scheduled (e.g., OSHA, TB, HIPAA, Abuse Prevention, Safety, etc.). Follow established... ...infectious materials and/or hazardous wastes or chemicals. Follow established handwashing...FraudFull timePart timeLocal areaShift work
- Highmark Health is seeking an analytical professional who will work on data aspects of business products from their Atlanta office. This position includes a hybrid work schedule requiring in-office presence on selected days. Candidates must have at least 3 years of experience...Remote jobWork at office
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