Conducting fraud, waste, and abuse investigations, the full-time remote Fraud Investigations Analyst will lead quality control efforts, manage regulatory deliverables, and ensure compliance with Medicaid standards while preparing documentation for regulatory inquiries. Key Responsibilities Conduct investigations into suspected fraud, waste, and abuse, including interviewing witnesses and documenting findings Perform quality control reviews of case files and ensure adherence to regulatory requirements and internal protocols Compile and organize response packages for Requests for Information from regulators and maintain tracking logs for deliverables Required Qualifications Bachelor's degree preferred; substantial professional experience may be considered in lieu of a formal degree 5-7 years of experience in LHCSA, MCO/health plan, and/or state regulatory Medicaid roles Prior experience in fraud investigations, program integrity, or compliance auditing required Experience preparing or responding to regulatory RFIs, audits, or corrective action plan documentation preferred Certification such as CFE, AHFI, or CCEP preferred
...Roustabout Oil & GasKeystone Clearwater SolutionsDepartment: Water TransferLocation: St. Clairsville, OHDescriptionA Roustabout will work in field operations for Keystone Clearwater Solutions clients. Assigned work will vary by location and staffing. Roustabouts...
...WordPress Developer We're looking for a motivated WordPress Developer to join our small dev team. This role is perfect for someone who's confident with core WordPress work but still enjoys collaborating and learning in a flexible, friendly setup. What You'll Do...
DescriptionKforce has a client that is looking for a ServiceNow Engineer in Jacksonville, FL.Overview:The client is looking for an experienced platform engineer to lead the ongoing development, optimization, and administration of a large-scale enterprise workflow and service...
...Motogistics Logisticsis seeking motivated team players to join our delivery team as Driver Helpers. Youll partner with our drivers to efficiently deliver Amazon packages to customers in your community. No experience is required, and we offer on-the-job training and...
...for you With Titan Medical, you gain access to thousands of travel nursing and allied health jobs across the country. You also get... ...developing your rsum, skills checklist and references. Travel CNA Location: Baltimore, MD, United States...