Senior Investigator - Fraud, Waste, and Abuse Job at Robert Half (Los Angeles)

Senior Counsel - Fraud, Waste & Abuse Attorney

This Senior Counsel in-house attorney will provide strategic legal counsel for B...

Location

United States , Deerfield

Salary:

224000.00 - 280000.00 USD / Year

Baxter

Expiration Date

Until further notice

Requirements

Juris Doctor (JD) from an accredited law school
admission to practice in relevant jurisdiction, active member in good standing
Strong academic record
Significant experience advising commercial teams in the healthcare/life sciences space on fraud and abuse laws
In-house experience supporting a pharmaceutical and/or medical device company will be highly desireable
Familiarity with regulatory frameworks governing medical devices and pharmaceuticals
Strong understanding of pharmaceutical and/or medical device commercialization
Exceptional oral written communication skills, including drafting skills and presentation capabilities
Excellent interpersonal and conflict resolution skills and ability to work in a highly collaborative, team-oriented environment
Ability to maintain an independent and objective perspective while developing and maintaining a strong partnership with the business and other functions

Job Responsibility

Provide legal guidance on arrangements that implicate referral, purchasing, influence, or reimbursement risk
Counsel the business on fraud and abuse laws, discount safe harbors, value-based arrangements and other commercial and regulatory areas
Develop internal expertise, programs and policies to ensure compliance with fraud and abuse laws
Serve as a legal representative on enterprise and cross-functional teams and projects
Support internal investigations and responses to government inquiries related to fraud and abuse topics
Assist in the auditing of the business and development and execution of remediation strategies
Monitor enforcement trends and other legal, regulatory, and governmental developments on fraud and abuse issues impacting the business
Advise leadership of emerging risks related to innovative contracting and market access models
Direct and manage outside counsel efficiently when needed

What we offer

Medical and dental coverage that start on day one
Insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
Employee Stock Purchase Plan (ESPP), with the ability to purchase company stock at a discount
401(k) Retirement Savings Plan (RSP), with options for employee contributions and company matching
Flexible Spending Accounts
Educational assistance programs
Paid holidays
Paid time off ranging from 20 to 35 days based on length of service
Family and medical leaves of absence
Paid parental leave

Fulltime

Senior Counsel - Fraud, Waste & Abuse Attorney

This Senior Counsel in-house attorney will provide strategic legal counsel for B...

Location

United States , Deerfield

Salary:

224000.00 - 280000.00 USD / Year

Baxter

Expiration Date

Until further notice

Requirements

Juris Doctor (JD) from an accredited law school
admission to practice in relevant jurisdiction, active member in good standing
strong academic record
significant experience advising commercial teams in healthcare/life sciences on fraud and abuse laws
familiarity with regulatory frameworks governing medical devices and pharmaceuticals
strong understanding of pharmaceutical and/or medical device commercialization
exceptional oral and written communication skills
excellent interpersonal and conflict resolution skills
ability to work in a collaborative, team-oriented environment
ability to maintain an independent and objective perspective

Job Responsibility

Provide strategic legal counsel for Baxter International
primary focus on compliance with US Fraud, Waste & Abuse laws (False Claims Act, federal Anti-Kickback Statute, Stark Law, related reimbursement and coverage issues, applicable state analogues)
provide practical, business-enabling advice to help reduce risk and help the business understand fraud and abuse laws and develop compliance strategies
FCA/AKS Counseling & Risk Management: provide legal guidance on arrangements that implicate referral, purchasing, influence, or reimbursement risk (GPO, IDN, regional and local agreements with customers
non-commercial arrangements with customers involving an exchange of value
distributor and sales-agent agreements
consulting, speaker, advisory board, and clinical education programs
grants, donations, sponsorships, and charitable contributions
data purchase, market research, and service agreements with HCPs and compliance with Sunshine Act
arrangements with customers when there are complaints about product performance

What we offer

Medical and dental coverage that start on day one
insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
Employee Stock Purchase Plan (ESPP) with ability to purchase company stock at a discount
401(k) Retirement Savings Plan (RSP) with employee contributions and company matching
Flexible Spending Accounts
educational assistance programs
time-off benefits: paid holidays, paid time off ranging from 20 to 35 days based on length of service, family and medical leaves of absence, paid parental leave
commuting benefits
Employee Discount Program
Employee Assistance Program (EAP)

Fulltime

Senior Investigator, Special Investigations Unit (Aetna SIU)

We’re building a world of health around every individual — shaping a more connec...

Location

United States

Salary:

46988.00 - 112200.00 USD / Year

CVS Health

Expiration Date

Until further notice

Requirements

3-5 years investigative experience in the area of healthcare fraud, waste and abuse
Experience in in Microsoft Word, Excel, and Outlook products, open source database search tools, social media and internet research
Ability to travel approximately 10% of time for business purposes

Job Responsibility

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 claims submitted by insured's, providers, claimants, and customers
Research and prepare cases for clinical and legal review
Document all appropriate case activity in case tracking system
Prepare written case summaries and make referrals to State and Federal Agencies within the timeframes required by Law
Facilitate the recovery of company and customer money lost as a result of fraud, waste and abuse
Cooperate with federal, state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud
Demonstrate high level of knowledge and expertise during interactions with internal and external partners
Provide trial testimony in support of criminal or civil proceedings
Give frequent presentations to internal and external customers regarding ongoing case investigations

What we offer

Medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
bonus, commission or short-term incentive program

Fulltime

Special Investigations Unit Senior Investigator

Conduct high level, complex investigations of known or suspected acts of healthc...

Location

United States

Salary:

46988.00 - 112200.00 USD / Year

CVS Health

Expiration Date

Until further notice

Requirements

3+ years investigative experience in the area of healthcare fraud and abuse matters
Working knowledge of medical coding
CPT, HCPCS, ICD10
Proficiency in Microsoft Office with advanced skills in Excel (must know how to do pivot tables)
Strong analytical and research skills
Proficient in researching information and identifying information resources
Strong verbal and written communication skills
Ability to travel up to 10% (approx. 2-3x per year, depending on business needs)
Bachelor's degree or equivalent experience (3+ years of working health care fraud, waste and abuse investigations)

Job Responsibility

Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business
Researches and prepares cases for clinical and legal review
Documents all appropriate case activity in case tracking system
Facilitates feedback with providers related to clinical findings
Initiates proactive data mining to identify aberrant billing patterns
Makes referrals, both internal and external, in the required timeframe
Facilitates the recovery of company and customer money lost as a result of fraud matters
Provides on the job training to new Investigators and provides guidance for less experienced or skilled Investigators
Assists Investigators in identifying resources and best course of action on investigations
Serves as back up to the Team Leader as necessary

What we offer

Medical, dental, and vision coverage
Paid time off
Retirement savings options
Wellness programs
and other resources based on eligibility

Fulltime

Bilingual Client Services Specialist

ServiceMaster Green is a values-driven, growing, locally owned ServiceMaster fra...

Location

United States , Urbandale

Salary:

18.00 - 20.00 USD / Hour

ServiceMaster by Prince

Expiration Date

Until further notice

Requirements

Previous customer Service experience, problem solving and communication
Computer skills (esp. Microsoft Office products)
Experience using Salesforce a plus
Clean criminal background
Valid Iowa driver's license with clean driving record
Legal adult authorized to work in the U.S.
Clean criminal record
Bilingual (English/Spanish) a plus

Job Responsibility

Work a variety of tasks, learning new things as every day is different
Completes administrative tasks as assigned
Inspect buildings for quality control of janitorial services
Create work orders and follow ups
Communicating regularly with clients to ensure we are meeting their needs
Drive to assigned properties and various locations as directed by management

What we offer

401(k)
401(k) matching
Competitive salary
Dental insurance
Health insurance
Paid time off

Fulltime

Associate Lecturer in Engineering

The Engineering Department is a dynamic and growing area of our technical educat...

Location

United Kingdom , Portsmouth

Salary:

29801.28 - 43644.02 GBP / Year

360 Resourcing Solutions

Expiration Date

Until further notice

Requirements

HNC or equivalent qualification in a relevant area or Relevant work experience
Experience of using a range of strategies to ensure students engage and partake in their lessons
Teaching Qualification in a relevant subject or willing to work towards (QTS/QTLS)
Ability to meet targets within set timescales
Ability to work well in teams but also to work independently, with the minimum of supervision
Computer literate

Job Responsibility

To teach on a range of programmes, providing high-quality learning opportunities that meet the needs of individual students/apprentices and groups in line with the College’s strategic priorities and objectives
To provide flexible assessment opportunities and closely plan, monitor, track and record student/apprentice retention, achievement, and success
To contribute to the development and delivery of high-quality, relevant curriculum and programmes
Actively contributing to the development of new programmes within the curriculum area
Producing annual schemes of work and/or training plans for all subjects/programmes to be taught

What we offer

Annual Leave: up to 42 days total and closure for winter shutdown period
Pension: Generous Local Government pension
Learning & Development: Programmes by The Community Adult Education Department
Staff Development: Access to the College staff development programmes and CPD
Onsite Discounts: City of Portsmouth College Hair Salon & 50% off at the City of Portsmouth College Sports Centre
Online Discounts: Unidays, Student Beans, and Totum with a City of Portsmouth College email address
Parking: Free car parking across all campus sites (apart from Arundel)
Blue Light Card: providing several discounts for clothing, electrical goods, food and days out

Team Member

As an Instore Team Member, you’ll be at the heart of our store, making delicious...

Location

United Kingdom , Workington

Salary:

10.85 - 13.00 GBP / Hour

360 Resourcing Solutions

Expiration Date

Until further notice

Requirements

Positive, can-do attitude and a passion for great customer service
No previous experience required - full training and induction provided
Able to work quickly and efficiently, especially during busy periods
Good communication skills and a team player
Attention to detail and pride in your work
Willingness to learn and take on new challenges
Right to work relevant to store location

Job Responsibility

Prepare pizzas and side items to Domino’s high standards
Serve customers face-to-face and by phone, taking orders and payments
Maintain food hygiene and safety standards at all times
Support with cleaning, restocking and general store duties
Contribute to local marketing activities (e.g. leaflet drops, events)
Work flexibly across shifts, including evenings and weekends

What we offer

Competitive hourly pay (with opportunities for progression)
28 days paid holiday per year (includes BH, pro rata for part time)
Flexible working hours to suit your lifestyle
Staff discount on our delicious food
Company pension scheme (where eligible)
Family Leave policies in place
Paid training and clear career progression pathway with linked pay increases
Supportive, inclusive, and fun team environment
Employee recognition opportunities

Evening Commercial Cleaner

This position is responsible for creating cleaner and healthier environments for...

Location

United States , Bend

Salary:

Not provided

ServiceMaster by Prince

Expiration Date

Until further notice

Requirements

1-2 years’ experience as a custodian, janitor, housekeeper a plus but not required
Experience working for a professional janitorial company, office complex, hotel, hospital or school is a plus
The ability to be flexible, work at a fast-paced and in a multi-tasked job is a must
Contribute to a positive work climate with a pleasant attitude and contribute to the overall team effort including being in uniform, dependable and on time
Has respect and understanding for co-workers and customers
Must be able to communicate in English
Ability to read cleaning instructions
Ability to differentiate between cleaning products and uses
Must be able to lift and/or carry 25lbs

Job Responsibility

Perform all cleaning duties for facilities using provided ServiceMaster products, tools and procedures
Cleaning duties include: sweeping, mopping, polishing, trash, windows and cleaning and moving furniture and equipment etc.
Maintain inventory of supplies and equipment
Use proper PPE where required
Opens and locks facilities, enable and disable security system as required

What we offer

Paid Training
Competitive Pay
Flexible Schedules
Career Path Opportunities
Positive Atmosphere
Paid Time-Off
No Weekends & Holidays

Parttime

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Senior Investigator - Fraud, Waste, and Abuse

Job Description

Job Responsibility

Requirements

What we offer

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