loss in order to minimize risk within the organization. This role involves developing and implementing controls and cost-effective approaches to mitigate risks associated with Medicaid operations within the company's... Payment Integrity Unit. The Senior Risk Management Professional assesses and communicat...
sources of loss in order to minimize risk. This role involves developing and implementing controls and cost-effective approaches to mitigate risks associated with Medicaid operations within the company's... Payment Integrity Unit. The responsibilities include: - Assessing and communicating contractual obligations re...
risk. - Lead and manage Medicaid litigation, coordinating with outside... counsel, internal stakeholders, and managing budgets to achieve favorable outcomes. - Apply knowledge of one or more legal specialties with sound business acumen and understanding of business goals related to legal matters....
The following jobs are no longer active but were real openings previously posted by employers. These listings provide valuable insight into employer hiring trends and frequently lead to job offers. In many cases, employers are still hiring or open to strong candidates even if no new job is posted. Applying to these listings often makes you the only applicant, increasing your chances of being hired.
Fraud and Waste Investigator The candidate coordinates investigation with law enforcement authorities. Assembles evidence and documentation to support successful adjudication, where appropriate. Conducts on-site audits of provider records ensuring appropriateness of billing practices. Prepares complex investigative and audit reports. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for proj... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
Clinical Fraud and Waste Professional The candidate assembles evidence and documentation to support successful adjudication, where appropriate. Conducts on-site audits of provider records ensuring appropriateness of billing practices. Prepares complex investigative and audit reports. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direc... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
Professional II The candidate ensures compliance with governmental requirements. Work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Develops and implements compliance policies and procedures. Researches compliance issues and recommends changes that assure compliance with contract obligations. Maintains relationships with government agencies. Coordinates site visits for regulators, c... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
- Military / Specialty The candidate will report to an Assistant General Counsel and support the company, its management and subsidiaries. Will provide legal guidance regarding the TRICARE program, enabling statutes, regulations and associated manuals. Support the provider contracting & relation teams with negotiating and managing the provider network which is comprised of institutional, ancillary and professional providers. Advise internal medical management, IT and... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
And Waste Investigator Responsibilities: The candidate coordinates the investigation with law enforcement authorities. Assembles evidence and documentation to support successful adjudication, where appropriate. Conducts on-site audits of provider records ensuring the appropriateness of billing practices. Prepares complex investigative and audit reports. Understands department, segment, and organizational strategy and operating objectives, including their linkages to re... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
Compliance Professional II Duties: Regular communication and presentation coordination needs to CCM Business SME/Medicaid Implementation Advisors, CMU or Auditors. Design and create standard reporting and metrics for CCM Compliance Team related activities. Oversee the development of compliance related policies and documentation. Identify and leverage best practices in compliance. Develop and maintain key relationships with business areas. Partner with CCM SMEs to success... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
Program Director - Strategic Medicaid Partnerships The candidate will... identify, design and implement strategic partnerships with a wide range of organizations to expand and enhance capabilities to support the Medicaid business and long-range Growth... plan. Will apply knowledge about the unique needs of specialized service populations (including people with intellectual and developmental disabilities, children in foster care, people with serious mental illness or other disabili... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
Program Director - Strategic Medicaid Partnerships The candidate will... identify, design and implement strategic partnerships with a wide range of organizations to expand and enhance capabilities to support the Medicaid business and long-range Growth... plan. Will apply knowledge about the unique needs of specialized service populations (including people with intellectual and developmental disabilities, children in foster care, people with serious mental illness or other disabili... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
Investigator The candidate will be responsible for investigating, collecting, researching and analyzing billing data in order to detect fraudulent, abusive or wasteful activities/practices on an enterprise wide basis for company's Special Investigations Unit. Using appropriate system tools, analyzes data to detect fraudulent, abusive or wasteful payments to providers and subscribers. Prepares statistical/financial analyses and reports to document findings and maintain... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
VP, Program Integrity / Investigations The candidate will provide leadership to the Commercial Special Investigations Unit, Provider Audit and Data Mining teams. Primary duties include: development and implementation of program strategies, goals, deliverables, and overall program execution. Develop and administer a strategy that continually reduces the inappropriate provider payments and optimizes opportunities to drive fraud, waste and abuse savings including identify... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here