Remote Healthcare FWA Investigator - Program Integrity
TriWest Healthcare Alliance
A healthcare organization is seeking a PI Investigator responsible for investigating fraud, waste, and abuse. This role requires 2 years of relevant experience and can be performed remotely in several U.S. states. The ideal candidate will have a background in healthcare claims analysis, data analysis techniques, and knowledge of billing regulations. Responsibilities include researching and documenting FWA issues, ensuring compliance with federal guidelines, and supporting the Program Integrity objectives. #J-18808-Ljbffr
- ...candidate to manage fraud, waste, and abuse (FWA) responsibilities effectively. This position involves conducting investigations, overseeing compliance, and ensuring... ...measures are implemented to uphold operational integrity and promote efficient systems. The ideal candidate...Remote jobWork from home
- ...with fraud, waste, and abuse (FWA) standards. This role involves developing effective FWA programs, conducting audits, and... ...least 2 years of experience in a healthcare setting focused on compliance... ...auditing. Strong communication and investigative skills are essential, along...Remote job
- ...professional to oversee their fraud, waste, and abuse program. The role includes developing effective measures to prevent and investigate fraud cases, preparing compliance reports, and providing training regarding FWA policies. Candidates should have a minimum of 2 years...Remote job
$70k - $90k
...Senior Investigator - Pre-Pay (Healthcare FWA) Job Location: US-Remote Overview As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis (a high level of proficiency with Excel is required). This is not...Remote workWork experience placementWork at officeWork from home$70k - $90k
...A leading healthcare analytics firm is seeking a Senior Investigator to investigate incidents of healthcare fraud, waste, and... ...abuse through data analysis. This remote position requires a Bachelor's... ...years of experience in healthcare FWA investigations, and advanced Excel...Remote work- ...a dynamic role focused on advocacy and program integrity through compliance management. Here, you... ...the quality of care, and influence healthcare outcomes on a meaningful scale. Enjoy the... ...outcomes for vulnerable populations Remote work - enjoy the convenience and balance...Remote workFull timeTemporary workWork at officeWork from home
$60.2k - $107.4k
A leading healthcare organization seeks a Senior Investigator Pharmacy to prevent and investigate healthcare fraud and abuse. Responsibilities include assessing misconduct complaints and analyzing trends. Required qualifications include a degree and relevant experience...Remote job- UnitedHealthcare is seeking a Senior Investigator in Columbus, Ohio to combat healthcare fraud, waste, and abuse. This position involves investigating complex cases using claims data and collaborating with federal/state regulators. Telecommuting flexibility is available...Remote job
- UnitedHealth Group is seeking a Senior Investigator responsible for identifying and preventing healthcare fraud, waste, and abuse. This role offers telecommuting flexibility and requires investigating complex fraud cases, analyzing data trends, and collaborating with regulatory...Remote job
- ...develop and operate effective fraud, waste, and abuse (FWA) programs. The role requires a minimum of 5 years in compliance and at least one year focusing on healthcare fraud. The candidate will perform FWA investigations, prepare detailed reports and educate staff on...Remote job
- ...professional with expertise in fraud, waste, and abuse (FWA) for a remote position. The ideal candidate will have a minimum... ...include developing and maintaining effective FWA programs, conducting advanced investigations, and preparing reports. The role offers competitive...Remote job
$60.2k - $107.4k
A healthcare organization is seeking a Senior Investigator responsible for identifying, investigating, and preventing healthcare fraud, waste, and abuse. This... ...travel. The position offers the flexibility to work remotely from anywhere in the U.S. Candidates should have at...Remote job- ...Compliance Analyst to contribute to the development and operation of an effective Fraud, Waste, and Abuse (FWA) program. Key responsibilities will include conducting investigations, preparing audit reports, and educating staff on compliance requirements. The ideal candidate will...Remote job
- ...Job Description Position Summary We are seeking a Senior Healthcare Fraud Investigator to support our program integrity efforts through hands-on investigation of potential fraud, waste, and abuse (FWA). This role is ideal for someone who thrives on digging into...Remote work
- ...efficient processes to program and patient health.... ...Responsibilities Payment Integrity & FWA Domain Expertise... ...payment recovery, SIU investigations, and provider fraud and... ...Bachelor’s degree in healthcare administration,... ...functions. This is an office/remote position. While...Remote workWork at officeShift work
- The Commonwealth of Massachusetts is hiring a Program Integrity Compliance Specialist in Boston. This full-time role focuses on supporting early childhood programs by investigating complaints and non-compliance issues. Candidates must have extensive experience in program...Full time
- ...issuance of all programmatic benefits. Investigators work in both an independent and team-oriented... ...to investigate allegations of possible program eligibility abuse and fraud, apply... ...for other functions of the Program Integrity unit as needed, including work assigned...Work experience placementWork at office
$1,833.39 per month
The State of Florida is seeking a Medical/Health Care Program Analyst in Orlando to conduct investigations and audits related to Medicaid fraud prevention. This full-time position requires strong analytical skills and the ability to travel. Salary is set at $1,833.39 biweekly...Full time$60k - $92k
...Levels (Investigator, Sr. Investigator, etc) will depend on experience... ...and qualifications. Integrity Advantage is a small... ...investigation and prevention of healthcare fraud, waste and abuse (FWA). We are growing and... ...work independently within a remote team, under minimal...Remote workFull time$71.3k - $124.5k
...CT, NY, NJ, PA, MD, DE, OH). Remote position but must reside in... ...adoption of best practices, integrating our solutions into curricula... ...nurses for a rapidly evolving healthcare landscape... ...of competitive benefits and programs to help meet your needs and...Remote workWork at office- CareOregon is looking for a professional to manage fraud, waste, and abuse compliance efforts. This role involves investigating FWA cases and preparing detailed reports for audit findings. Candidates should have a minimum of 5 years in audit or compliance, including a year...Work from home
- ...JOB DESCRIPTION Provides investigative support for special... ...coding fraud, waste and abuse (FWA). Investigates and resolves instances... ...), and applicable software program(s) proficiency. In some... ...Internal Job Board. Molina Healthcare offers a competitive benefits...Remote workContract workWork at officeLocal area
- ...a dynamic role focused on advocacy and program integrity through compliance management. Here, you... ...the quality of care, and influence healthcare outcomes on a meaningful scale. Enjoy the... ...outcomes for vulnerable populations Remote work - enjoy the convenience and balance...Remote workFull timeTemporary workWork at office
- ...reflection of our clients and the people they serve. Healthcare Compliance Investigator I Work Location: Remote - Must be Licensed in the State of Ohio Position... ...the federal laws relating to the F-1 STEM EAD program, this position is not eligible to support a STEM EAD...Remote workH1bWork at officeWork from homeFlexible hours
$85.1k - $95k
Title FRAUD INCIDENT PROGRAM MANAGER Status EXEMPT Report To DIRECTOR... ...FRAUD PREVENTION AND RISK INVESTIGATIONS Job Code 11966 Pay Range $... ..., and ensure operational integrity and compliance with... ...seven days a week; occasional remote diagnosis; occasional travel...Remote workWork experience placementWork at officeLocal area$49.7k - $88.8k
...within the organization Conduct investigations of low- to moderately complex... ...Employee Assistance Program Employee Referral Bonus Program... ...Qualifications Experience in healthcare fraud, waste, and abuse investigations... ...regulations related to FWA Experience with data analysis...Remote jobMinimum wageFull timeTemporary workWork experience placementLocal areaMonday to Friday$60.2k - $107.4k
Senior Investigator At UnitedHealthcare, we're simplifying the health care... ...and prevention of healthcare fraud, waste and abuse. The Senior... ...full and comprehensive benefit program, performance rewards, and a management... ...care fraud, waste and abuse (FWA) 2+ years of experience in...Remote jobMinimum wageFull timeTemporary workWork experience placementLocal areaMonday to Friday- Adams County is seeking an experienced Community Support Case Manager in Commerce City, Colorado. The role involves investigating allegations of program eligibility abuse, communicating with various stakeholders, and maintaining comprehensive reports. Candidates should...
- Health First is seeking a qualified individual to investigate and detect potential healthcare fraud, waste, and abuse (FWA) in New York. The primary responsibilities include conducting audits of medical records, analyzing billing practices, and preparing reports for law...Full timeWork at officeDay shift
$53k - $99k
A leading healthcare organization in Honolulu is looking for an investigator to manage, resolve, and prevent Fraud, Waste, and Abuse cases. You will work with various... ...skills and a fundamental understanding of FWA. This full-time role offers a hybrid work environment...Full time
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