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

New

Pharmacy Technician

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

Location

United States , Worthington

Salary:

17.00 USD / Hour

CVS Health

Expiration Date

October 03, 2026

Requirements

Must comply with any state board of pharmacy requirements or laws governing the practice of pharmacy, which includes but is not limited to, age, education, and licensure/certification
If the state board of pharmacy does not address or mandate a minimum age requirement, must be at least 16 years of age
If the state board of pharmacy does not address or mandate a minimum educational requirement, must have a high school diploma or equivalent, or be actively enrolled in high school or high school equivalency program
Regular and predictable attendance, including nights and weekends
Ability to complete required training within designated timeframe
Attention and Focus: Ability to concentrate on a task over a period of time
Ability to pivot quickly from one task to another to meet patient and business needs
Ability to confirm prescription information and label accuracy, ensuring patient safety
Customer Service and Team Orientation: Actively look for ways to help people, and do so in a friendly manner
Notice and understand patients’ reactions, and respond appropriately

Job Responsibility

Living our purpose by following all company SOPs at each workstation to help our Pharmacists manage and improve patient health
Following pharmacy workflow procedures at each pharmacy workstation (i.e., production, pick-up, drive-thru, and drop-off) for safe and accurate prescription fulfillment
Contributing to positive patient experiences by showing empathy and genuine care: creating heartfelt and personalized moments while serving patients at pick-up, drive-thru, and over the phone
keeping patients healthy by offering immunizations and other services at the register and over the phone
and demonstrating compassionate care by solving or escalating patient problems
Completing basic inventory activities, as permitted by law, and as directed by the pharmacy leadership team, such as accurately putting away medication deliveries and completing cycle counts, returns-to-stocks, waiting bin inventories, etc.
Contributing to a high-performing team, embracing a growth mindset, and being receptive to feedback
actively seeking opportunities to expand clinical and technical knowledge needed to better assist patients
Remaining flexible for both scheduling and business needs, while contributing to a safe, inclusive, and engaging team dynamic
voluntarily traveling to stores in the market to work shifts as needed by the business

What we offer

Medical, dental, and vision coverage
Paid time off
Retirement savings options
Wellness programs

Fulltime

New

Office Manager

We are looking for a dependable Office Manager to support daily workplace operat...

Location

United States , New York

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Prior experience in office management, workplace coordination, administrative support, or a similar business support role
Demonstrated ability to manage office supply ordering, inventory upkeep, and general workplace organization
Comfortable handling front desk or receptionist-style responsibilities, including greeting visitors and managing deliveries
Experience supporting meetings, team activities, or office events with strong attention to setup and follow-through
Strong organizational skills with the ability to manage multiple daily tasks consistently and independently
Reliable and proactive work style, with a willingness to step in and solve problems as office needs change
Clear communication skills and a service-oriented approach to creating a positive onsite experience

Job Responsibility

Oversee the day-to-day flow of the office to ensure employees and guests experience a well-organized, detail-focused workplace
Arrange and manage onsite meal service, including coordinating lunch orders, preparing serving areas, and handling cleanup afterward
Prepare morning hospitality offerings such as coffee service and weekly breakfast setup to keep shared spaces ready for the team
Monitor inventory levels for office, kitchen, and snack supplies, and replenish materials as needed to maintain a fully stocked environment
Accept incoming deliveries and mail, sort items promptly, and distribute packages to the appropriate recipients
Serve as the first point of contact for visitors by providing a friendly reception experience and maintaining a hospitable office atmosphere
Support internal gatherings and onsite events by assisting with logistics, room readiness, food coordination, and post-event reset
Address routine workplace issues as they arise, taking initiative to resolve operational needs quickly and effectively

What we offer

Medical, vision, dental, and life and disability insurance
401(k) plan

New

Help Desk/Desktop Support Analyst

Seeking an IT Support Specialist to provide technical support across desktop, ne...

Location

United States , Exeter

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

3+ years of IT support, help desk, or systems support experience
Experience using ticketing platforms such as ServiceNow, Jira, Zendesk, or similar
Strong knowledge of TCP/IP, DHCP, VPNs, and network troubleshooting
Experience supporting Microsoft Windows, Microsoft 365, and Active Directory
Excellent customer service, communication, and problem-solving skills

Job Responsibility

Manage and resolve end-user support requests through a ticketing system
Troubleshoot hardware, software, and connectivity issues
Diagnose and resolve TCP/IP, DHCP, DNS, VPN, and network-related problems
Support users across on-premises and hybrid cloud environments
Document issues, resolutions, and support procedures

What we offer

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

New

Pharmacy Technician

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

Location

United States , Waterbury

Salary:

18.94 - 28.94 USD / Hour

CVS Health

Expiration Date

August 22, 2026

Requirements

Must be at least 16 years of age
Licensure requirements vary by state
Attention and Focus: The ability to concentrate on a task over a period of time without being distracted
Customer Service Orientation: Actively look for ways to help people, and do so in a friendly manner
Notice and understand customers' reactions, and respond appropriately
Communication Skills: Use and understand verbal and written communication to interact with customers and colleagues
Actively listening by giving full attention to what others are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times
Mathematical Reasoning: The ability to use math to solve a problem, such as calculating day's supply of a prescription
Problem Resolution: Is able to judge when something is wrong or is likely to go wrong
recognizing there is a problem

Job Responsibility

Manage all assigned pharmacy workstations and tasks to support the team's ability to promptly, safely and accurately fill patient prescriptions
Provide caring service that exceeds customer expectations
Complete an extensive CVS Pharmacy Technician Training Program
Satisfy all registration, licensing and certification requirements according to State's Board of Pharmacy guidelines

What we offer

Dental
Vision
Wellness resources
Employee discounts
Access to certain voluntary benefits
Other programs

Parttime

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Senior Investigator - Fraud, Waste, and Abuse

Job Description

Job Responsibility

Requirements

What we offer

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