• Senior Fraud , Waste ,…

    Sharp HealthCare (San Diego, CA)
    …for the position, and employer business practices. **What You Will Do** The Senior Fraud , Waste and Abuse Specialist at Sharp Health Plan is a critical ... role responsible for overseeing the entire lifecycle of fraud , waste , and abuse (FWA)...ensuring compliance with regulatory, accreditation and contract standards. The Senior FWA Specialist will manage day-to-day anti- fraud more
    Sharp HealthCare (10/02/24)
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  • Fraud Waste and Abuse (FWA)…

    Fallon Health (Worcester, MA)
    …position supports the Senior Director of Internal Audit in their leadership of the Fraud , Waste and Abuse (FWA) program. The FWA Manager will be ... summary of purpose:** Under the general direction of the Senior Internal Audit Manager, theAnalyze and interpret patient medical...+ Assist in the development, implementation and manage strategic fraud , waste and abuse (FWA)… more
    Fallon Health (11/09/24)
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  • Senior Fraud and Waste

    Humana (Indianapolis, IN)
    **Become a part of our caring community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity ... Officer, who will oversee the monitoring and enforcement of the fraud , waste , and abuse (FWA) compliance program to prevent and detect potential FWA… more
    Humana (11/07/24)
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  • Healthcare Fraud Senior Manager,…

    CVS Health (Wellesley, MA)
    …activities. **Investigation Management:** + Direct and oversee complex investigations into suspected healthcare fraud , waste , and abuse . + Ensure timely and ... a Sr. Manager to lead our new ASO investigations team. The Healthcare Fraud Senior Manager is responsible for overseeing and managing fraud detection,… more
    CVS Health (11/02/24)
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  • Sr Program Manager - Fraud Investigations,…

    Amazon (Arlington, VA)
    …and uses signals in transactional data such as invoices and payments as indicators of theft, fraud , waste , or abuse . We are looking for a technical minded ... on best practices, identify training gaps and opportunities for fraud investigators, and manage upwards with senior ...for fraud investigators, and manage upwards with senior leaders. You will have a strong background in… more
    Amazon (09/21/24)
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  • Pharmacy Fraud Investigator-Remote

    The Cigna Group (St. Louis, MO)
    …Functions:** + Directly interact with multiple levels within partner organization to coordinate Fraud Waste and Abuse activities. Interactions will include ... meetings with attendees including partner Senior Managers and Directors. + Coordinate multiple investigations to...internal investigators. + Facilitate triage and coordination of partner fraud tips and communicate the outcomes in an intelligent,… more
    The Cigna Group (11/08/24)
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  • Senior Investigator (Hybrid)

    CareFirst (Columbia, MD)
    …through the detection, investigation, and resolution of all levels (low to complex), of fraud , waste , and abuse schemes, resulting in the savings and ... or as lead in part of an assigned team develop and conduct healthcare fraud , waste , and abuse investigations of all levels (low to complex). Develop and… more
    CareFirst (10/28/24)
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  • Special Investigations Unit (SIU) Senior

    CVS Health (Hartford, CT)
    …**Education:** - Bachelor's degree or an additional 5 years of working health care fraud , waste and abuse investigations. **Pay Range** The typical pay ... will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse . Routinely handles cases that are sensitive or high… more
    CVS Health (11/10/24)
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  • Senior Human Services Program Specialist

    MyFlorida (Tallahassee, FL)
    68064375 - SENIOR HUMAN SERVICES PROGRAM SPECIALIST Date: Nov 1,...is to ensure fewer budgeted dollars are lost to fraud , abuse , and waste . The ... Agency for Health Care Administration Working Title: 68064375 - SENIOR HUMAN SERVICES PROGRAM SPECIALIST Pay Plan: Career Service... Human Services Program Specialist position will support the fraud and abuse prevention efforts within the… more
    MyFlorida (10/30/24)
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  • Senior Policy Analyst, GOPP

    State of Massachusetts (Boston, MA)
    …public money and property. The OIG is an independent agency charged with preventing and detecting fraud , waste and abuse in the use of public funds and ... functions. Together the bureau work to prevent and detect waste , fraud and abuse of...of Construction Management At-Risk projects and public land dispositions. * Senior Policy Analyst: Position Overview* As part of the… more
    State of Massachusetts (11/09/24)
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