Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Lead Payment Integrity & Fraud Insights (Remote)

Centene Corp.

Kansas City, MO
  • Remote job

Centene Corp. is seeking a seasoned professional to develop, implement, and manage strategic fraud, waste and abuse activities across our managed care programs. You will monitor billing and claims payment integrity and lead analysts to ensure compliance with state and federal requirements. The role requires a bachelor’s degree and at least 4 years in medical claim investigation or compliance, with strong knowledge of medical terminology. #J-18808-Ljbffr Centene Corp.

Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Lead Payment Integrity & Fraud Insights (Remote) in Kansas City, MO vacancy
  •  ...focusing on developing and managing fraud, waste and abuse programs for...  ...and federal requirements and leading a team of analysts. The role...  ...monitoring billing/claims integrity, conducting investigations,...  ...in required settings. Remote/hybrid options and a comprehensive... 
    Remote job
    Fraud

    Centene Corp.

    Brooklyn, NY
    2 days ago
  •  ...partner for the Special Investigations Unit and Payment Integrity teams. You will deliver business intelligence, financial reporting, and operational insights, combining data analysis with stakeholder engagement to identify fraud, waste, abuse, and payment accuracy... 
    Fraud

    Blue Cross and Blue Shield of North Carolina

    Brooklyn, NY
    1 day ago
  • $112.7k - $193.2k

     ...UnitedHealth GroupOptum Insight is improving the flow...  ...Growing together.The Payment Integrity Platform organization...  ..., provider integrity, fraud detection, clinical review...  ...healthcare costs.As a Lead Technical Product...  ...the flexibility to work remotely * from anywhere within... 
    Remote work
    Fraud
    Minimum wage
    Full time
    Work experience placement
    Work at office
    Local area

    UnitedHealth Group

    Eden Prairie, MN
    2 days ago
  • $112.7k - $193.2k

     ...UnitedHealth GroupOptum Insight is improving the flow of...  ...strategy for one of Optum Payment Integrity's Intelligent Fraud Detection products. This...  ...the flexibility to work remotely * from anywhere within the...  ...enabled platformsExperience leading or mentoring other... 
    Remote work
    Fraud
    Minimum wage
    Full time
    Work experience placement
    Work at office
    Local area
    Shift work

    UnitedHealth Group

    Eden Prairie, MN
    4 days ago
  • Centene Management Company LLC is seeking a seasoned Fraud, Waste and Abuse (FWA) professional in Missouri to develop and manage strategic FWA activities across state and federal programs. You will lead analysts, monitor billing and claims processes, and ensure compliance... 
    Remote job
    Fraud

    Centene Management Company LLC

    Kansas City, MO
    3 days ago
  • $166k - $220k

     ...seeking an experienced EW Mission Integration Lead with prior training and...  ...engineers.Conduct onsite and remote troubleshooting support with...  ...scammers often attempt to extract payment or sensitive personal...  ...links.What to Do If You Suspect Fraud: Should you encounter any questionable... 
    Remote work
    Fraud
    Full time
    Contract work
    Work experience placement
    Immediate start

    Anduril Industries

    Costa Mesa, CA
    2 days ago
  • $98.2k - $163.6k

     ...Business Analytics Advisor, Payment Integrity - Cigna Healthcare - RemoteApplyremote...  ..., with a strong ability to lead complex initiatives, reduce...  ..., reduce waste, prevent fraud, and deliver measurable business...  ...automation, AI-driven insights, and reusable data assets to... 
    Remote job
    Fraud
    Work from home

    Cigna Health and Life Insurance Company

    Bloomfield, NJ
    3 days ago
  • Elevance Health is seeking a Carelon Payment Integrity Manager - Kansas to oversee accuracy of claims payments, prevent errors, and ensure compliance...  .... The role collaborates with health plan leaders to monitor fraud, waste, and abuse programs and to enforce related policies.... 
    Fraud

    The Elevance Health Companies, Inc.

    Overland Park, KS
    3 days ago
  •  ...policy development, presenting findings to senior management, and leading Prepay Compliance Managers to reduce waste, abuse, and fraud. Responsibilities also include designing and implementing payment integrity edits, monitoring regulatory changes, and delivering training... 
    Remote job
    Fraud

    Centene Management Company LLC

    Kansas City, MO
    3 days ago
  • $112.8k - $257k

    SOC Task & Integration LeadThe Opportunity:As a Security Operations Center (SOC) Task Lead, you’re in the middle of the action, responding...  ...and protect against identity fraud. You are expected to be on camera...  ...cameras on during meetings.Remote: If this position is listed... 
    Remote work
    Fraud
    Full time
    Contract work
    Part time
    Work at office
    Local area

    Booz Allen Hamilton

    Huntsville, AL
    2 days ago
  • Centene Corporation seeks a senior leader to supervise the Coding & Clinical Review team within Payment Integrity, ensuring accurate DRG assignments and audit outcomes. This remote role drives quality, efficiency, and adherence to AHIMA standards while coordinating cross-... 
    Remote job

    Centene Corporation

    Kansas City, MO
    2 days ago
  • UMB Bank is seeking a Sr. Fraud BI Analyst to design and develop dashboards, reports, data...  ...data analytics and presenting actionable insights to leadership. Applicants should have a...  ...hybrid role supports Mon-Thu on-site and Fri remote work within the US. #J-18808-Ljbffr UMB... 
    Remote work
    Fraud

    UMB Bank

    Phoenix, AZ
    4 days ago
  • A leading healthcare solutions firm seeks a Payment Integrity Supervisor to oversee daily operations of the payment integrity team. Responsibilities include managing...  ...a focus on improving service delivery. This remote position requires strong experience in claims processing... 
    Remote job
    Daily paid

    CorVel

    Fort Worth, TX
    1 day ago
  • $99k - $225k

    Palantir Mission Integration LeadThe Opportunity:As a Palantir Mission Integration Lead, you will lead full lifecycle software development...  ...and protect against identity fraud. You are expected to be on...  ...their cameras on during meetings.Remote: If this position is listed as... 
    Remote work
    Fraud
    Full time
    Contract work
    Part time
    Work at office
    Local area

    Booz Allen Hamilton

    Fort Belvoir, VA
    4 days ago
  • $190k - $230k

     ...planning, design, delivery, systems integration, assurance, safety and...  ...Systems Design Coordination Lead based in our San Francisco office...  ...global profit share scheme (payments are dependent on the firm’s...  ...Stay safe online. Recruitment fraud is on the rise, and Arup’s... 
    Remote work
    Fraud
    Contract work
    For contractors
    Work at office
    Flexible hours

    Arup

    San Francisco, CA
    4 days ago
  •  ...-on, technically fluent Product Manager to build and scale our payments platform—the system that moves money from customer funding to settlement...  ...cross‑functional collaboration with engineering, finance, fraud, and operations, plus a bias for action. #J-18808-Ljbffr Félix
    Remote job
    Fraud

    Félix

    Miami, FL
    4 days ago
  •  ...is seeking a Medical Review Manager to lead the Program Integrity medical reviews nationwide. You will...  ...candidates possess deep Medicare knowledge, fraud-focused review experience and a master...  ...or bachelor’s in nursing. This fully remote/office role collaborates with CMS and... 
    Remote work
    Fraud
    Work at office

    DOMA Technologies

    Annapolis, MD
    3 days ago
  • United States Digital Space LLC is seeking a Senior Payments Performance Analyst to lead data-driven optimisation discussions with existing and prospective...  ...tools to reduce card network costs, improve acceptance, fraud controls, and cross-border flows, partnering with Sales... 
    Remote job
    Fraud

    United States Digital Space LLC

    New York, NY
    2 days ago
  • Félix is a payments platform leader moving money across borders for the Latino community in the United States. You will own the payments...  ...ownership, data-driven decision making, and collaboration with fraud, finance, and business development to expand payment methods... 
    Remote job
    Fraud

    Félix

    New York, NY
    4 days ago
  • $160k - $180k

     ...represent our values of integrity, transparency,...  ...Overview The Lead Product Manager will...  ...locations. Fully remote work is not...  ...quantitative and qualitative insights into opportunity...  ...number of hiring fraud schemes across...  ...requires advance payments of any kind for computer... 
    Remote work
    Fraud
    Work at office
    Local area
    Work from home

    Planet Fitness

    Hampton, NH
    1 day ago
  • CorVel Corporation seeks a Payment Integrity Analyst (Team Lead) to supervise the Policy and Payment Integrity (PPI) team while overseeing audits per...  ...staff training, and timely completion of audits, with a remote work arrangement. Strong knowledge of CMS policies, ICD-... 
    Remote job

    CorVel Corporation

    Fort Worth, TX
    1 day ago
  • $99k - $225k

    Program Integrator, LeadThe Opportunity: As a Program Integrator, you know...  ...for someone like you to lead a team of experienced professionals...  ...and protect against identity fraud. You are expected to be on...  ...their cameras on during meetings.Remote: If this position is listed as... 
    Remote work
    Fraud
    Full time
    Contract work
    Part time
    Work at office
    Local area

    Booz Allen Hamilton

    El Segundo, CA
    1 day ago
  • $107.7k - $199.3k

     ...ensure accurate and timely payments of coding and pricing...  ...internal payment integrity edit and audit programs...  ...accurate coding. Direct and lead Prepay Compliance...  ...reduce waste, abuse, and fraud. Performs other duties...  ...approach to work with remote, hybrid, field or office... 
    Remote work
    Fraud
    Full time
    Part time
    Work at office
    Flexible hours

    Centene Corp.

    Brooklyn, NY
    2 days ago
  • $112.2k - $151.8k

     ...Engineer (Experienced or Lead)Company:Build the...  ..., analysis, integration, and test.On the Boeing...  ...provide mission insight used by MDA and...  ...onsite (no hybrid or remote options). The...  ...student loan debt payments counted, along with...  ...from recruitment fraud! The only way to apply... 
    Remote work
    Fraud
    Full time
    Work experience placement
    Currently hiring
    Immediate start
    Relocation
    Visa sponsorship
    Work visa
    Flexible hours
    Shift work

    Boeing

    Huntsville, AL
    4 days ago
  • Centene Corporation seeks an RN with coding credentials to lead Payment Integrity initiatives focused on preventing readmissions, cost recovery, and payment accuracy. You will guide a team, align with internal policies and regulatory requirements, and drive DRG-related... 
    Remote job

    Centene Corporation

    Florida, NY
    15 hours ago
  • Head of Payments (Remote - Vertical ERP)Company OverviewWe are...  ...Head of Payments to lead and scale the payments...  ...across operations, risk, integrations and commercial...  ...operationalize risk, fraud and compliance programs...  ...CAC impact) and present insights to executive leadership... 
    Remote work
    Fraud

    CyberCoders

    Provo, UT
    1 day ago
  • $87.7k - $157.8k

     ...implement and manage strategic fraud, waste and abuse activities by maintaining...  ...processes and systems to assure integrity and compliance in billing and claims payment Lead teams of analysts to...  ...flexible approach to work with remote, hybrid, field or office work schedules... 
    Remote work
    Fraud
    Full time
    Contract work
    Part time
    Work at office
    Immediate start
    Flexible hours

    Centene Management Company LLC

    Kansas City, MO
    3 days ago
  • $86.8k - $198k

     ...Job Number: R0238682 Integration Architect and API Lead The Opportunity: Are you looking for an opportunity...  ...and protect against identity fraud. You are expected to be on camera during...  ...cameras on during meetings. Remote : If this position is listed as remote... 
    Remote work
    Fraud
    Full time
    Contract work
    Part time
    Work at office
    Local area

    Booz Allen Hamilton

    Arlington, VA
    2 days ago
  • Elevance Health is seeking a Carelon Payment Integrity Manager in Kansas to oversee claims payment accuracy and fraud, waste, and abuse prevention. The role collaborates with health plan leaders and cross-functional teams to enforce compliance with state and federal rules... 
    Fraud
    Work at office

    Elevance Health

    Overland Park, KS
    3 days ago
  • $120.8k - $169.1k

     ...Lead Merchant Risk Analyst Remote, USA Since 2018, Wisetack has been...  ...leading VCs, including Insight Partners, Greylock,...  ...to merchant fraud across the merchant...  ...fraud, merchant risk, payments risk, or financial...  ...data, or fraud vendor integrations ~ Experience... 
    Remote work
    Fraud
    For contractors

    Wisetack

    United States
    4 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Lead Payment Integrity & Fraud Insights (Remote). Be the first to apply!