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

Trade Communications Executive

This role supports B2B communications for the travel trade across social media, ...

Location

United Kingdom , London

Salary:

Not provided

Disney

Expiration Date

Until further notice

Requirements

Experience in marketing or communications, including email or social media activity
Strong written communication and copywriting skills
Experience using CRM or email marketing tools (e.g. HubSpot, or Pixie Dust)
Experience of copywriting
Highly organised with strong attention to detail
Comfortable working within established processes and guidelines
Able to manage multiple tasks and priorities effectively
Experience using Microsoft Office tools (Word, Excel, PowerPoint) as well as CANVA
Collaborative approach and confidence working with stakeholders
Highly motivated and positive 'Can Do' attitude

Job Responsibility

Plan, schedule and deliver social media content across trade-facing channels, making sure activity supports agreed objectives and reflects best practice
Work closely with the Brand Social Media team and other internal stakeholders to align messaging, share ideas and deliver content accurately and on time
Maintain the communications calendar across campaigns, incentives and events, ensuring activity is well organised, tracked and delivered to schedule
Support the delivery of email campaigns through CRM tools such as HubSpot, including set-up, design and audience segmentation, with guidance where needed
Carry out quality checks to ensure all communications are clear, accurate, on brand and ready for distribution
Coordinate communications for trade events, including invitations, follow-up materials and wider event-related messaging
Help manage the day-to-day administration of trade communications activity across multiple Disney Destinations brands
Produce basic reporting on B2B communications and social media performance, sharing key observations and insights with the wider team
Build strong working knowledge of the team's communications and CRM tools, and support colleagues by sharing knowledge and following agreed processes and standards
Stay up to date with trends and developments in communications and social media, while supporting ad hoc budget tracking in partnership with your manager

What we offer

25 days annual leave
Private medical insurance & dental care
Free Park Entry: You will have the opportunity to enter any of our parks with your family and friends for free
Disney Discounts: you are entitled to discounts on designated Disney products, resort F&B and ticketing
Excellent parental and guardian leave
Employee Resource Groups - WOMEN @ Disney, Disney Mosaic, Disney PRIDE, our disability & neurodiversity focused group - ENABLED, and our Mental Health & Wellbeing Group, TRUST

Fulltime

Senior Medical Information Manager

SRG are partnered with a leading Global Pharmaceutical Company who have an oppor...

Location

Ireland , Dublin

Salary:

33.00 - 38.00 GBP / Hour

SRG

Expiration Date

Until further notice

Requirements

Life sciences degree and/or postgraduate qualification
Significant experience within Medical Information (ideally including above country level experience)
Strong knowledge and application of good practices in medical enquiry management and writing for medical information
Experience with reviewing medical/clinical content and providing constructive feedback
Strong cross-functional skills and proven experience in collaboration with other departments/groups

Job Responsibility

Handle Medical Information (MI) enquiries in an efficient and appropriate manner
Collaborate with the MI function in the affiliate countries to ensure consistency and alignment in communication
Provide product related, clinical guidance to sales & marketing teams
Supporting Medical Information activities at congresses
Developing content for digital platforms

Fulltime

Sr Manager, Retail Marketing

The Sr Manager, Retail Marketing, is responsible for the strategy, development, ...

Location

United States , Bentonville

Salary:

120800.00 - 161900.00 USD / Year

Disney

Expiration Date

Until further notice

Requirements

8+ years Retail Marketing experience and industry knowledge
Demonstrated leadership across direct and indirect reporting relationships
Ability to demonstrate strategic thinking, clarity of communications and management of multiple business stakeholders
Exceptional presentation and negotiating skills
Data-driven and results-oriented, with the ability to communicate and optimize in real-time
Adaptable and responsive – can thrive in ambiguous business situations and in rapidly evolving retail environments including digital and e-commerce
Ability to collaborate, influence and persuade at all levels of an organization
Comfortable working through a matrix structure to deliver business objectives and share best practices
Proven ability to build strong relationships with key account stakeholders
Financial acumen and understanding retail marketplace, P&L, market research and data analysis

Job Responsibility

Partner with the Walmart retail sales team to help develop comprehensive, future-focused, strategies to achieve business goals & objectives.
Lead end to end marketing strategy for Walmart retail channels that enables sustained growth through sales and marketing initiatives.
Lead omni-channel retail marketing plans inclusive of in-store, e-commerce, retail media networks, creator & affiliate programs, loyalty, and CRM integration to drive consumer engagement and conversion.
Develop marketing programs and presentations for Walmart buyer and marketing teams.
Maintain current knowledge of industry trends, competitors, consumer insights, business opportunities.
Create actionable recommendations to key stakeholders and seek out knowledge of competitive retailer program execution to share best practices.
Develop measurable performance frameworks and dashboards to optimize programs using data, consumer insights, A/B testing, and ROI metrics.
Collaborate with and influence licensees, internal promotional partners and with the other divisions of The Walt Disney Company to ensure optimal execution of retail strategies/programs.
Fiscal responsibility for budgeting, decision-making, tracking and reconciliation of retail marketing budget in partnership with the Director of Retail Marketing.
Manage key promotional deliverables for all internal & external parties (including retailer agencies) to deliver on-time and cost-efficient programs.

What we offer

health and savings benefits
educational opportunities
special extras that only Disney can provide
bonus and/or long-term incentive units
full range of medical, financial, and/or other benefits

Fulltime

Coordinator, Marketing Film Campaigns

The Coordinator, Marketing Film Campaigns will join the team to support Studio M...

Location

Mexico , Tlalpan

Salary:

Not provided

Disney

Expiration Date

Until further notice

Requirements

Bachelor's degree in Marketing, Communications, Administration or related fields
+2 year of experience in similar roles
Working knowledge of Microsoft Office (Word, Excel, Power Point)
Ability to manage multiple priorities in a fast-paced environment
Proactive, flexible and collaborative
Creative mindset with strong execution orientation
Advanced level of English

Job Responsibility

Coordinate efforts around the marketing plans for Studios Marketing (Disney Plus and theatrical) to fulfill the initiatives of each marketing plan
Responsible for the administrative processes involved in the marketing plans (create purchase orders, management with vendors and contracts)
Implement key actions in each title that help in the success of marketing campaigns
Be the link between the marketing strategies and the rest of the departments and third parties (exhibitors, vendors) involved in the plans to provide the appropriate tools in time
Gather information from the different areas for analysis post release of each title

Fulltime

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Senior Investigator - Fraud, Waste, and Abuse

Job Description

Job Responsibility

Requirements

What we offer

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