Healthcare Fraud Investigator & Anti-Fraud Program Lead
Highmark Health
Highmark Inc. seeks an investigations professional to develop and maintain an anti-fraud program, conduct field investigations, and coordinate with law enforcement to recover misappropriated funds. The role conducts interviews with providers and members, prepares cases for referrals, and ensures compliance with HIPAA and internal policies. Required are a Bachelor's degree or equivalent experience, 3+ years in health insurance fraud investigations, and strong communication and analytical skills. #J-18808-Ljbffr
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...growing! Hiring multiple Senior Data Team Leads across our FSP (Functional Service... ...expertise shapes the future of data-driven healthcare!IQVIA is a leading global provider of clinical... ...a zero tolerance policy for candidate fraud. All information and credentials submitted...Full timePart timeImmediate startRemote workWork from homeWorldwide$43.89k - $93.57k
...reviews for the Special Investigations Unit (SIU) to ensure... ...transportation and other healthcare providers. The CPC... ...billing errors, abuse, and fraud. • Identify... ...National Health Care Anti-Fraud Association (AHFI... ...short-term incentive program in addition to the base...Hourly payFull timeTemporary workLocal area- ...reputable pharmaceutical advertising and healthcare communications is hiring a talented... ...remote team. This contract role involves leading creative development for multiple healthcare... .... ~ Life Insurance. ~401(k) Program. ~ Commuter Benefit. ~ eLearning and...Contract workRemote work
- ...State of West Virginia seeks a senior program leader to direct the state opioid response project, overseeing grants and collaborating with partner agencies to expand access to evidence-based MOUD and services for high-priority populations. The role emphasizes training,...
- ...Adjusting, Home Appraisals, Real Estate or Construction is a plus. Experience using Rapid Sketch, Xactimate, CAD or other diagramming programs will be helpful. As a Field Consultant, you will be responsible for scheduling and conducting on-site High Value Property Surveys...For contractorsWork from homeHome officeFlexible hours
- ...deliver high-quality perioperative care across all phases while adhering to standards and policies. Requirements: graduation from an accredited nursing program, active RN license in the state, BLS; ACLS after orientation; and PALS within 6 months of hire. #J-18808-Ljbffr...
- ...that lacks personalization, behavioral healthcare can leave people feeling unseen and unsupported... ...Health: Flexibility: Our virtual program allows clinicians the ability to work from... ...be cautious of potential recruitment fraud. If you are interested in exploring opportunities...Full timePart timeFor contractorsLocal areaRemote workWork from home
- ...Physical Therapist Lead -- Physical Therapy -- Memorial Hospital(Job Id 79119) Location... ...lead position will be responsible for program implementation, quality assurance, and... ...and comprehensive patient care. Investigate and assist in problem solving regarding...Full timeLocal areaMonday to FridayShift workWeekend work
$20 - $22 per hour
...Physician Led Advanced Geriatric Care Program focused on the quality of care... ...mission: To help our patients lead healthier, meaningful lives by... ...of experience working for a healthcare practice or hospital EMR... ...conducts monthly FACIS (Fraud and Abuse Control Information...Contract workLocal area- ...Weatherby Healthcare seeks a nephrologist for a locum tenens assignment in Charleston, WV. The schedule is Monday to Friday, 8 am to 4:30 pm with night and weekend call on all days. The role covers both inpatient consults and outpatient nephrology clinic duties. Duties...LocumMonday to FridayNight shiftWeekend work
- ...Weatherby Healthcare seeks a locum nephrologist for inpatient consults and outpatient nephrology clinic coverage in Charleston, WV. Schedule is M-F, 8 am - 4:30 pm, approx. 40 hours per week, with night and weekend call on all days. Responsibilities include dialysis oversight...LocumNight shiftWeekend work
$27 - $30 per hour
...Overview At Genesis Healthcare, we are dedicated to improving the lives we touch through the... ...care and exceptional service. As a leading provider in the long-term care industry,... ...audits to insure preventative maintenance programs are being adhered to Qualifications High...Temporary workImmediate start- Signature Companies is seeking experienced High Value Residential Insurance Inspectors to join as independent contractors (1099) across West Virginia. This remote field role will manage on-site surveys, document high-end features, and communicate findings for underwriting...For contractorsRemote work
$71.2k - $166.1k
...will partner with the strategy lead on projects for health system... ...requirements mandates and healthcare data relationships across members... ..., and identification of fraud vulnerabilities. + **Project... ...communities through our volunteer programs. We're committed to including...Contract workTemporary workFlexible hours- ...CommuniCare's Charleston Healthcare Center is seeking an RN Supervisor to lead weekend and evening shifts in Charleston, WV. You will oversee nursing staff,... ...experience, and a nursing degree from an accredited program. We offer a team‑oriented environment with comprehensive...Weekend workAfternoon shift
$112.7k - $193.2k
...Manager - 2392598 Opportunities with Genoa Healthcare. A career with Genoa Healthcare means... ...pharmacies, medication management and more - are leading the way to a new level of care. Genoa is... ...package, incentive and recognition programs, equity stock purchase and 401k...Minimum wageFull timeWork experience placementLocal areaMonday to Friday$74.6k - $93.3k
...Strategic Partnerships and Communications Lead Opportunity As the nation’s original travel insurance comparison site, InsureMyTrip,... ...or growing affiliate, referral, partner, or business development programs. Excellent written and verbal communication skills, with strong...Work experience placementWork at officeLocal areaWork from home$25 - $50 per hour
...supervise Transportation Security Officers and Lead Transportation Security Officers,... ...successfully complete the required background investigation Must be able to obtain and maintain... ...; participation in a federal retirement program and the Thrift Savings Plan; flexible...Permanent employmentFull timeTemporary workTrial periodFlexible hoursShift workNight shiftWeekend workDay shiftAfternoon shiftEarly shift- ...insurance comparison site, seeks a Strategic Partnerships & Communications Lead to drive growth through partnerships, affiliate marketing, and communications strategies. You will lead affiliate programs, craft media outreach, and develop data-driven content to boost brand...
- ...CommuniCare Health's Crestview Manor Healthcare Center is seeking an experienced RN Supervisor to join a world-class, patient-centered... ...WV RN licensure, has long-term care and supervisory experience, and a nursing degree from an accredited program. #J-18808-Ljbffr...Daily paid
$60.94 per hour
...Job Details Strategic Field Enablement Lead (Contract) Location: Remote (Preferably for candidates located near an office)... ...Strategic Field Enablement Lead to drive adoption of global enablement programs across North America and EMEA. This role serves as the...Contract workWork at officeRemote work- ...contractor duties, review plans, and generate progress reports on site. The role requires liaising with project teams, managing material flow, outages, and safety programs while maintaining OSHA compliance and quality performance on multiple sites. #J-18808-LjbffrFor contractorsLocal area
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