Remote Human Services Fraud & Program Integrity Specialist
Commonwealth of Pennsylvania
The Commonwealth of Pennsylvania is seeking a Human Services Program Specialist to join the Department of Human Services. This full-time position involves analyzing information to identify fraud and waste within essential programs. Candidates will assist in supporting fair practices within the Bureau of Program Integrity through case analysis and report preparation. The ideal candidate has experience with human services programs and strong analytical skills. Opportunities for part-time telework are available, allowing flexibility on select days. #J-18808-Ljbffr
- BLH Technologies, Inc., is seeking a Program Integrity Specialist to support a federal contract with the U.S. Department of Health and Human Services (HHS). This role will support HHS by... ...preventing, and mitigating risks related to fraud, waste, and abuse (FWA). This...FraudContract work
- ...role focused on advocacy and program integrity through compliance... ...vulnerable populations Remote work – enjoy the convenience... ...medical assistance, health care services or human services or any equivalent... ...policies and identify potential fraud, waste, or abuse. Review...Remote workFraudFull timeTemporary workWork at officeWork from home
- ...role focused on advocacy and program integrity through compliance... ...vulnerable populations Remote work - enjoy the convenience... ...medical assistance, health care services or human services or any equivalent... ...and identify potential fraud, waste, or abuse related to...Remote workFraudFull timeTemporary workWork at office
$52.59k - $92.04k
...Program Coordinator IV (NS) The North Carolina Department... ...of Health and Human Services (DHHS) is one of the largest... ...the Medicaid program integrity function under the... ...for the control of fraud and abuse in the Medicaid... ...5 Position is 100% remote Candidates now meet...Remote workFraudWork experience placementWork at officeLocal areaNight shift- Agency Dept of Health and Human Services Division HEALTH... ...Classification Title Program Coordinator IV (NS) Position... ...the Medicaid program integrity function under the... ...requirements for the control of fraud and abuse in the... ...75 **Position is 100% remote** Candidates now meet...Remote workFraudPermanent employmentFull timeTemporary workWork experience placementWork at officeLocal areaNight shift
- ...seeking a Lead Medical Coder to serve as an expert in medical coding and Medicaid program integrity. This position focuses on ensuring compliance with coding standards and reducing fraud, waste, and abuse. As the subject matter expert, you will develop training materials...Remote workFraud
$86.9k - $198k
...Systems Integration Specialist The Opportunity: Are you... ...and Control ( MOBC2 ) program and assist with future... ...integrate into the C2 service suites supporting... ...protect against identity fraud. You are expected to... ...during meetings. Remote : If this position is...Remote workFraudFull timeContract workPart timeWork at officeLocal area- ...Integration Specialist The Integration Specialist provides Health Home services and similar supports for patients whose... ...accordance with Health Home program requirements: health... ...of assault, abuse, fraud, or crimes that have... ...~ BSW or BA/BS in Human Services, Health...Remote workFraudTemporary workWork at office
- ...We are seeking an experienced Payment Integrity Specialist to support healthcare claims accuracy,... ...project coordination, and payment integrity programs. This individual will work closely with... .... Knowledge of claims auditing, fraud/waste/abuse prevention, or overpayment...Remote workFraud
- ...Investigator responsible for investigating fraud, waste, and abuse. This role requires 2... ...experience and can be performed remotely in several U.S. states. The ideal candidate... ...with federal guidelines, and supporting the Program Integrity objectives. #J-18808-LjbffrRemote workFraud
- Nashville Public Radio seeks a Program Integrity Investigator to identify and analyze fraud cases under Department of Defense guidelines. Applicants require 2 years... ...and a High School diploma. This role emphasizes remote work across various states, ensuring compliance...Remote jobFraud
- The Commonwealth of Pennsylvania is seeking a Human Services Program Specialist Supervisor to oversee a team of specialists, perform provider audits... ...involves collaborative work with data analysis to combat fraud and improve service delivery. Candidates should meet residency...Remote workFraudPart time
$145k - $160k
Public Partnerships LLC is seeking a Senior Director of Program Integrity to lead the organization’s fraud, waste, and abuse program. This role involves... ...interpersonal and analytical skills. The position supports remote work and includes benefits such as health insurance...Remote workFraud- ...Senior Program Integrity Specialist Applicants must be permanent in the Fraud Investigator Civil Service Title. As one of the Mayor's critical initiatives to ensure a government-issued photo identification card that also provides access to City services, IDNYC benefits...FraudPermanent employmentFlexible hoursAfternoon shift
$120k - $140k
...a Senior Consultant with expertise in Medicaid program integrity and claims audits. The role involves assisting clients in detecting fraud and conducting audits while ensuring compliance with federal regulations. Remote, hybrid, or office work is available, primarily...Remote workFraudWork at office- ...Description APPLICANTS MUST BE PERMANENT IN THE FRAUD INVESTIGATOR CIVIL SERVICE TITLE As one of the Mayor's critical initiatives... ...three (3) Fraud Investigator II to function as Senior Program Integrity Specialist who will: - Conduct thorough, more complex and...FraudPermanent employmentFull timeFlexible hoursAfternoon shift
- ...Responsibilities Program Development & Oversight – Design and... ..., and billing integrity. Establish workflows, referral... ...formal referral process to fraud, waste, and abuse specialists when education does not result... ...Benefits Work‑flexible hybrid or remote role with autonomy and...Remote workFraudFlexible hours
$130k - $170k
...supply chain management services to the US Coast Guard.... ...software engineering, program management, strategic... ...- Sensors & Systems Integration who will lead programs... ...Ability to work effectively remotely in cross-functional... ...identity and prevent fraud. If you require...Remote workFraudWork at officeLocal area$55.1k - $99k
...this job have the flexibility to work remote from home anywhere in the Continental United... ...Purpose Maintain compliance with program integrity related regulatory laws and standards,... ...analyze state program integrity, including fraud, waste and abuse detection,...Remote workFraudContract workWork at officeWork from homeFlexible hours$80k
...Medical Program Integrity Auditor Minimum Salary US-MA-Westborough... ...Director or designee, the Fraud, Waste, and Abuse (FWA)... ...other aspects of the job are remote. Responsibilities... ...Access) ~ Excellent Customer service skills with the ability to interact...Remote workFraudFull timeWork at officeShift work$45k - $60k
...health and well-being with programs proven to achieve... ...the database platform, integrating data from delivery... ...program planning in social services and developing program... ...in social sciences, human services, public health... ..., in the field, and remote work as needed. Equal...Remote workFull timeContract workWork at office$63k - $68k
...Overview Medicaid/Medicare Program Integrity Analyst II - REMOTE The Medicaid/Medicare... ...allegations of potential fraud. Recommends and/or implements... ...Group's objective: To provide services to our clients that exceed... ..., please contact: Human Resources; (***) ***-****; humanresources...Remote workFraudFor contractorsWork at officeLocal areaWorldwideHome office$107.9k - $172.64k
...Description The Provider Education Program Manager is responsible for... ...; and partners with Payment Integrity, Provider Relations,... ...behavior suggests potential fraud, waste, or abuse. Prepare referral... ...giving you flexibility to work remotely with intentional in‑person connection...Remote workFraudWork at officeLocal areaFlexible hoursShift work2 days per week- ...For roles that are 100% remote or hybrid, you must... ...residing in states where service is required by... ...services and award-winning programs. AmeriHealth Caritas is... ...need it most. We offer integrated managed care products,... ...of business, manages fraud, waste and abuse (FWA)...Remote workFraudContract workFlexible hours
- ...Serco is seeking an Experienced Compliance/Fraud Specialist in Fairfax, VA. This role supports the CMS Eligibility Support program and involves conducting compliance reviews, fraud risk management, and working cross-functionally with teams. Ideal candidates will have 5...Fraud
- ...State-of-Washington is seeking a Medical Program Specialist 3 to ensure compliance in medical coding and prevent fraud in healthcare programs. The role involves training... ...certifications and experience in health services, with strong abilities in data analysis and communication...Remote workFraudFlexible hours
- ...more efficient processes to program and patient health. We combine... ...care. Responsibilities Payment Integrity & FWA Domain Expertise Serve... ...investigations, and provider fraud and billing scheme... ...functions. This is an office/remote position. While performing the...Remote workFraudWork at officeShift work
$55.2k - $126k
...Job Number: R0238251 Space Segment Program Integrator, Mid The Opportunity Are you looking for an... ...authenticity and protect against identity fraud. You are expected to be on camera... ...have their cameras on during meetings. Remote : If this position is listed as remote,...Remote workFraudFull timeContract workPart timeWork at officeLocal area- ...The Texas Health and Human Services Commission is seeking a dedicated professional in Austin, TX, to manage and oversee complex projects related to fraud prevention for various health programs. The successful candidate will engage with internal and external stakeholders...Remote workFraudFull time
$120k - $140k
...Senior Consultant For Medicaid Program Integrity And Claims Audits... ...prevention and detection of fraud, waste, and abuse. This individual... ...claims audits. You will work remotely, hybrid, or in one of our... ...codes, system configuration, service limits, system requirements,...Remote workFraud
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