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

Accountant

We are seeking a detail-oriented Accountant to support daily accounting operatio...

Location

United States , Miami

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Bachelor’s degree in Accounting, Finance, or related field
2+ years of accounting experience
Knowledge of general accounting principles and financial reporting
Experience with general ledger, reconciliations, and close processes
Proficiency in Microsoft Excel and accounting software or ERP systems
Strong attention to detail, organization, and problem-solving skills
Ability to work independently and collaboratively in a team environment
Strong written and verbal communication skills

Job Responsibility

Prepare and record journal entries, accruals, and adjustments
Maintain and reconcile general ledger accounts
Perform monthly bank and account reconciliations
Assist with month-end, quarter-end, and year-end close
Prepare financial statements, reports, and supporting schedules
Analyze account activity and investigate discrepancies
Support accounts payable, accounts receivable, and payroll processes as needed
Help ensure compliance with company policies, internal controls, and accounting standards
Assist with audits by preparing documentation and responding to requests
Contribute to budgeting, forecasting, and variance analysis

What we offer

medical insurance
vision insurance
dental insurance
life insurance
disability insurance
401(k) plan

Fulltime

Critical Environment Technician Manager

In alignment with our Microsoft values, we are committed to cultivating an inclu...

Location

United States , Mount Pleasant

Salary:

75400.00 - 167900.00 USD / Year

Microsoft Corporation

Expiration Date

Until further notice

Requirements

High School Diploma, GED, or equivalent AND 3+ years mission critical services work/applied learning experience (e.g., high availability assembly/manufacturing/critical infrastructure environments such as data centers, oil and gas refineries, hospitals, pharmaceutical, manufacturing, or related fields) OR equivalent experience
Ability to work shifts, including shift assignments during non-standard business hours that may include evening, nighttime, weekends, and/or holidays
Ability to meet Microsoft, customer and/or government security screening requirements are required for this role
High School Diploma, GED, or equivalent AND 6+ years mission critical services experience OR Associate's Degree or technical trade certification (e.g., military, trade school), or higher-equivalent education AND 5+ years mission-critical services experience OR equivalent experience
1+ year(s) people management experience
1+ year(s) experience in a specialized area (e.g., mechanical field, electrical field, controls field) or related field

Job Responsibility

People Management: Managers deliver success through empowerment and accountability by modeling, coaching, and caring. Model - Live our culture
Embody our values
Practice our leadership principles. Coach - Define team objectives and outcomes
Enable success across boundaries
Help the team adapt and learn. Care - Attract and retain great people
Know each individual’s capabilities and aspirations
Invest in the growth of others
Equipment and Systems Operations: Serve as an operations specialist one or more major area of operations (e.g., electrical, mechanical, controls, generators, and work on advanced tasks independently. Oversee and coach team with the inspection of critical environment-related facility equipment (e.g., controls, heating, ventilation, and air conditioning [HVAC], mechanical systems), building, and grounds regularly for unsafe or abnormal conditions to develop and analyze trends. Monitor performance of maintenance and operations utilizing telemetry, control systems, and other platforms and is able to identify all alarms. Utilize internal computerized maintenance management system (CMMS) to track all equipment assets and to complete work order requests for maintenance work and generate reporting to identify outstanding and ongoing work orders. Safely and quickly respond to and lead an onsite incident response team for all abnormal conditions that impact operations and coordinate with other critical facilities professionals to perform corrective repairs. Enhances, develops new, or follows preexisting emergency operating procedures (EOPs), methods of procedure (MOPs), and standard operating procedures (SOPs) in relation to incidents. Gathers necessary information and creates incident timelines/data, root-cause analyses, and/or action items following an abnormal condition
Equipment and Systems Maintenance: Guide, oversee, and perform various types of maintenance (e.g., planned, predictive, corrective) and repairs following methods of procedure (MOPs), and standard operating procedures (SOPs) for one or more disciplines and one or more types of equipment (e.g., electrical, mechanical, cooling systems) and escalate when appropriate. Serve as a subject matter expert for one type of equipment and oversee everyday tasks and troubleshooting within their area of expertise. Have a hands-on understanding of how equipment works within disciplines they have been trained and how to troubleshoot equipment, systems, subsystems, and components independently within their trained discipline(s). Provide and/or assign team to provide necessary escort to third-party contractors, sub contractors, vendors, and service providers on site for all severity leveled procedures. Coordinate and schedule supplier/vendor on-site activities and recognizes circumstances when to stop supplier work to address potential and/or identified concerns. Take part in getting third-party work underway (e.g., making sure systems are properly energized/deenergized), ensuring the work is started and completed in a safe manner in accordance with standard practices, procedures, federal/local legislation, and municipal codes. Advises junior colleagues on inspection and supervision issues. Provides consultation to lower-level colleagues in troubleshooting systems and problems
Critical Environment Culture: Understands, follows, ensures, and coaches team on safety and security requirements (e.g., job hazard assessments [JHAs], toolbox talks), and business processes and procedures to properly perform work in a safe, quality, and reliable manner in accordance with applicable federal, state, local, and Microsoft requirements. Proactively ensures safety and security requirements are followed and met for the work of themselves and others. Maintain safe working conditions and escalate immediately when unsafe working conditions are observed. Assesses and identifies appropriate resources and equipment necessary to fully support environmental health and safety (EH&S) objectives. Participates in required meetings, trainings, and necessary handoffs

What we offer

Benefits and other compensation (details at https://careers.microsoft.com/us/en/us-corporate-pay)

Fulltime

Psychologist/Psychological Assessment and Evaluation

Join a clinician-centered multidisciplinary team of counselors, social workers, ...

Location

United States , Georgetown

Salary:

Not provided

Ellie Mental Health

Expiration Date

Until further notice

Requirements

Clinical licensure is required (PhD or PsyD)
Experience with completing diagnostic evaluations, scoring and interpreting results, writing reports that clients can understand, and providing feedback to clients
Comfort and familiarity working with a diverse client base from an affirming perspective
Candidates must be able to work in Maryland with a Maryland license, or be license-eligible
Opportunity to provide supervision to psychology associates and trainees for qualified candidates with a demonstrated history of success with Ellie

Job Responsibility

Completing diagnostic evaluations
Scoring and interpreting results
Writing reports that clients can understand
Providing feedback to clients
Providing supervision to psychology associates and trainees for qualified candidates

What we offer

Competitive salary
Flexible schedule
Opportunity for advancement
Health insurance
PTO
Weekly case consultation groups
Free CEUs
Monthly team activities focused on clinician well-being
We will cover all testing costs and expenses as well as administrative tasks like marketing, scheduling, and billing
Cash pay service: clients pay upfront, and you’ll earn 50% of what we collect

Fulltime

Temporary Lettings Administrator

As a Lettings Administrator, you will play a vital role in managing a portfolio ...

Location

United Kingdom , Manchester

Salary:

30000.00 GBP / Year ▼

Office Angels

Expiration Date

Until further notice

Requirements

Strong administration and customer service skills
Previous experience in property management is a bonus
Excellent communication, organisational and problem-solving abilities
Confident in working independently and taking the initiative
A proactive mindset with a genuine care for delivering outstanding service
Full UK driving licence and access to a vehicle (mileage allowance provided)

Job Responsibility

Manage a diverse portfolio of student rental properties across Manchester
Conduct regular property inspections to ensure everything is in tip-top shape
Coordinate tenancy check-ins and check-outs like a pro
Handle rent collections, deposit returns and tenancy agreements efficiently
Address tenant queries and resolve issues promptly and professionally
Conduct viewings and manage enquiries during the bustling student letting cycle
Oversee health and safety, fire safety and compliance across all properties

What we offer

Opportunity to transition into a permanent role for the right candidate
Work in a fun and dynamic environment that values your growth
Make a real difference in the lives of students and enhance their rental experience
Mileage allowance provided

Fulltime

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Senior Investigator - Fraud, Waste, and Abuse

Job Description

Job Responsibility

Requirements

What we offer

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