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

Assistant Floor Supervisor

Run sold room reports, verify room status, determine discrepant rooms, prioritiz...

Location

Greece , Athens

Salary:

Not provided

Marriott Bonvoy

Expiration Date

Until further notice

Requirements

High school diploma or G.E.D. equivalent
At least 1 year of related work experience
No supervisory experience
None

Job Responsibility

Run sold room reports, verify room status, determine discrepant rooms, prioritize room cleaning, and update status of departing guest rooms
Assist Housekeeping management in managing daily activities
Act as a liaison to coordinate the efforts of Housekeeping, Engineering, Front Office, and Laundry
Document and resolve issues with discrepant rooms with the Front Desk
Prepare and distribute room assignments to Housekeeping staff
Record, monitor, and update list of 'Do Not Disturb' rooms
Ensure that vacant dirty rooms are cleaned by the necessary time and assign rush rooms and rooms previously on the 'Do Not Disturb' list
Complete required Housekeeping paperwork
Follow all company and safety and security policies and procedures
report any maintenance problems, safety hazards, accidents, or injuries

Fulltime

Process Engineer - Manufacturing

A growing manufacturing organization is seeking a Process Engineer to support an...

Location

United States , Omaha

Salary:

75000.00 USD / Year

MMC Group LP

Expiration Date

Until further notice

Requirements

Bachelor's degree in Manufacturing, Industrial, Mechanical, or Production Engineering, or related field
OR 3 to 5 years of relevant manufacturing or process engineering experience
Process design, development, and continuous improvement
APQP methodologies and documentation
Lean manufacturing tools and principles
Strong analytical and problem-solving capabilities
Ability to manage multiple projects in a fast-paced environment
Proficiency in Microsoft Office, particularly Excel
Strong written and verbal communication skills

Job Responsibility

Develop, implement, and sustain manufacturing processes and production methods
Create and maintain APQP documentation, including PFMEA, Control Plans, Standard Work, and Work Instructions
Perform process validation and qualification to ensure consistent, high-quality output
Design and improve processes in alignment with OSHA safety standards and operational requirements
Align production capabilities with customer demand and capacity planning needs
Lead continuous improvement initiatives using Lean manufacturing methodologies
Analyze production data to reduce cycle times, improve workflows, and increase efficiency
Support capital projects, including cost justification, equipment selection, and implementation
Lead equipment installation, commissioning, and operator training
Collaborate cross-functionally with operations, engineering, and production teams

What we offer

Health, dental, and life insurance
401(k) with company match
Paid time off and holidays
Profit sharing and tuition reimbursement

Fulltime

Receptionist

Our hospitality client is seeking a friendly and service-oriented Receptionist t...

Location

United States , Honolulu

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Previous receptionist, front desk, or customer-facing administrative experience
Experience handling phones and providing excellent customer service
Strong verbal and written communication skills
Professional appearance and welcoming demeanor
Ability to multitask in a fast-paced environment
Basic computer proficiency and familiarity with office systems
Strong reliability, punctuality, and problem-solving skills

Job Responsibility

Welcome guests and visitors and provide a high level of customer service
Answer, screen, and direct incoming phone calls promptly and professionally
Assist with check-in support, visitor coordination, and general inquiries
Maintain the front desk and reception area in a neat and professional manner
Coordinate messages, mail, packages, and deliveries
Provide administrative support such as filing, data entry, and scheduling
Communicate with internal departments to help ensure smooth guest and office operations
Handle customer concerns professionally and escalate issues when appropriate

What we offer

Medical
Vision
Dental
Life and disability insurance
401(k) plan

Fulltime

Assistant Food & Beverage Manager

Position responsible for assigned food and beverage/culinary operations. Oversee...

Location

India , Goa Anjuna

Salary:

Not provided

Marriott Bonvoy

Expiration Date

Until further notice

Requirements

High school diploma or GED
3 years experience in the food and beverage, culinary, or related professional area
OR 2-year degree from an accredited university in Food Service Management, Hotel and Restaurant Management, Hospitality, Business Administration, or related major
1 year experience in the food and beverage, culinary, or related professional area

Job Responsibility

Creates and nurtures a property environment that emphasizes motivation, empowerment, teamwork, continuous improvement and a passion for providing service
Provides excellent customer service to all employees
Responds quickly and proactively to employee's concerns
Uses coaching skills throughout the property
Demonstrates self confidence, energy and enthusiasm
Motivates and encourages staff to solve guest and employee related concerns
Provides excellent customer service
Responds quickly and proactively to guest's concerns
Understands the brand's service culture
Sets service expectations for all guests internally and externally

Fulltime

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Senior Investigator - Fraud, Waste, and Abuse

Job Description

Job Responsibility

Requirements

What we offer

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