The Clinical Investigator Consultant handles the retrospective review of paid claims and evaluation of claims data to identify provider fraud, waste, or abuse. The Clinical Investigator will conduct in-depth analysis of peers, trends, and statistical data to identify providers whose utilization patt...
As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through. This is not a physical investigator role. Preferred certifications:Accredited Healthcare Fraud Investigator (AHFI),Certified Fraud Specialist (CFS),Certified Fraud Examiner (CFE),Certifie...
You could be the one who changes everything for our 28 million members.Centene is transforming the health of our communities, one person at a time.As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.Investigate al...
Qlarant has an immediate opening for a Healthcare Fraud Lead Investigator to provide supervision and mentoring to a team of Investigators. Supervises intake investigators and/or investigators and assigns work; regularly reviews team’s leads in screening and/or investigations and actions for qu...
Architectural Historian (Principal Investigator) . ...
The Investigator independently performs in-depth evaluation and makes field level judgments related to investigations of potential Medicare fraud, waste and abuse investigations or cases that meet established criteria for referral to the Centers for Medicare & Medicaid for administrative action ...
Investigator Contracts Analyst is responsible for direct site-facing contract and budget negotiations thought contract execution with assigned clinical investigator sites including initial agreements and amendments and oversight of other contracting professionals on assigned studies. Follow GPD proc...
The Investigator should demonstrate proficiency in the following areas: Must be motivated and possess a strong work ethic Must be customer service driven Able to format/type/edit full reports of background research findings Proficient with Microsoft Word and Microsoft Outlook Ability to take directi...
The Manager interacts interdepartmentally with Global R&D Sourcing (GRDS), Global Clinical Operations (GCO), Investigator Contracts Management (ICM), and Data Management teams for clinical study budget development. ...
Credentialed Background InvestigatorJob Category: Service Contract ActTime Type: Full timeMinimum Clearance Required to Start: Top SecretEmployee Type: RegularPercentage of Travel Required: Up to 25%Type of Travel: Local* * *. Join CACI's Dynamic Team – Seeking Credentialed Background Investigators ...
Analyze and identify links between fraudulent transactions to identify and stop fraud rings . Interact with customer service and customers through various forms of communication and assist analysts with customer escalations . Collaborate with team to discuss new and emerging fraud trends . ...
Responsible for supporting Coinbase’s internal audit plan through the execution of operational and compliance related audits from beginning to end. Audit, Risk, Compliance, Trade Operations or Management Consulting. Excellent understanding of an internal control environment and working knowledge of ...
Project Details:Role:Radio Systems Project ManagerLocation:Remote allowed / Should be able to work onsite or offsiteDuration:6+ months/longtermType:Contract Job Description: Description: Education: B. The Project Manager may be responsible for multiple projects simultaneously. Responsible f...
The Information Systems Security Officer (ISSO) will support the development and maintenance of Authority to Operate (ATO) packages, provide cybersecurity planning, and ensure compliance with relevant security standards and guidelines. Provide cybersecurity planning and maintenance services, includi...
As a PRS Lead Case Manager, you will be responsible for supervision of case managers and/or case support workers. Assist with hiring, training and supervising of some program staff (case managers, case support workers and/or case aides);. Assist in onboarding new case managers and case support worke...
The Implementation Project Manager I will clarify and define project requirements and deliver projects within necessary and agreed upon timelines. The Implementation Project Manager I – HE Operations is responsible for providing assistance for multiple projects and related activities that are typica...
Analyst, Compliance (Transaction Monitoring). In this role, you will work with a team of experienced compliance professionals responsible for critical functions within the Compliance and AML/BSA/Sanctions program. Compliance at Gemini is a team dedicated to managing the next generation of financial ...
Case Manager Home Study and Post Release Services- Bilingual English/Spanish- Remote in Indiana. The Post Release Services (PRS), Case Manager is primarily responsible for Post Release Services (PRS) for Unaccompanied Children (UC) and families. Effectively maintain case capacity and trending of all...
The Senior Project Manager oversees a project delivery resources/team to ensure the use of standardized project management methodologies, processes and tools; provides leadership, direction, mentorship; coaches and ensures the professional development/expertise of internal and 3rd party team members...
The Case Manager must have the ability to work in a high-volume environment to better serve our members. RNs provide consultation, recommendations and education as appropriate to non-RN case managers. Active, unrestricted Certified Case Manager (CCM). We are seeking a Registered Nurse with previous ...
Our ideal case manager is caring, compassionate, solution-oriented and enthusiastic about providing an outstanding experience for Devoted Health’s members. We want to help members navigate the healthcare system in a better and safer way, and case management is critical to achieving this for our most...
Do you have experience working as a Compliance Analyst in a highly regulated environment such as banking, insurance, consumer lending, or healthcare? Does your experience include developing, conducting and managing a compliance program? This position involves building, execution, and oversight ...
Are you passionate about travel and love helping others plan their perfect trips? We're looking for an enthusiastic individual to join our team as a Remote Administrative Assistant. If you’re ready to combine your passion for travel with the flexibility of working remotely, apply now and start...
Marketing Administrative Assistant. This role will support many needs, from general administrative tasks and data entry to event planning and scheduling. Prior administrative experience preferred. ...
Strategic Staffing Solutions is currently looking for an RN Case Manager for a contract opportunity with one of our largest healthcare clients!. The Care Manager RN uses the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the member’s heal...