- Fallon Health (Worcester, MA)
- …the Senior Director of Internal Audit in their leadership of the Fraud , Waste and Abuse ( FWA ) program. The FWA Manager will be responsiblefor general ... Assist in the development, implementation and manage strategic fraud , waste and abuse ( FWA ) activities by maintaining state and federal requirements and… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- Position Purpose: The Manager - Fraud , Waste & Abuse ( FWA ) is responsible for day-to-day activities of the FWA Program while meeting operational and ... WorkPlan, and related activities + Detect, investigate and report fraud , waste and abuse cases + Lead special investigations, maintain FWA records,… more
- Molina Healthcare (Grand Rapids, MI)
- …escalations are achieved. Coordinates with both the Associate Vice President of Fraud , Waste and Abuse ( FWA ) and Associate Vice President of Special ... regulations and internal policies and procedures related to detecting, correcting, and preventing fraud , waste and abuse . Responsibilities may include data… more
- BlueCross BlueShield of North Carolina (NC)
- …Investigations Unit (SIU) is responsible for overseeing and managing fraud , waste , and abuse ( FWA ) detection, investigation, and prevention efforts ... skill sets, cutting edge analytics tools, and robust processes to identify FWA schemes and direct investigations to resolve issues effectively and efficiently. The… more
- CenterLight Health System (NY)
- …ensuring the adherence to DOH and CMS guidelines and to prevent fraud , waste , and abuse ( FWA ). JOB RESPONSIBILITIES: + Treasury responsibilities: + ... and balances for every account across all entities. Identify potential FWA ( fraud , waste and abuse ) and work with key stakeholders to mitigate risks and… more
- Corewell Health (Grand Rapids, MI)
- …Special Investigations Unit (SIU). Responsible for developing and directing the fraud , waste and abuse ( FWA ) program processes and oversight and ... objectives . + Maintains and revises policies and procedures, fraud , waste , and abuse plans,...matters. Represents the SIU in various state and/or federal FWA related regulatory meetings. Ensures that Priority Health meets… more
- CVS Health (Albany, NY)
- …coordinating interdepartmental program integrity initiatives, vendor oversight of fraud waste and abuse ( FWA ) activity, and identifying services ... for compliance with state and federal regulations mandating the reporting of corporate fraud related activities and the preparation of the corporate Anti- Fraud … more
- Centene Corporation (Austin, TX)
- …good faith concerns regarding Medicare non-compliance and potential instances of fraud , waste and abuse ( FWA ) + Responding to reports of potential ... + Maintaining documentation for each report of potential non-compliance or potential FWA received from any source, through any reporting channel or mechanism +… more
- CVS Health (Trenton, NJ)
- …manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse ( FWA ). **Key Responsibilities** + Conduct high level, ... complex investigations of known or suspected acts of healthcare fraud , waste and abuse . + Conduct Investigations to prevent payment of suspect or fraudulent… more
- Martin's Point Health Care (Portland, ME)
- …and external audits + Provides support for staff involved in investigating Fraud , Waste and Abuse ( FWA ) allegations received via the hotline and other ... experience with DHA audits required + Previous Compliance, Integrity, FWA or directly related experience preferred Skills/Knowledge/Competencies (Behaviors): +… more