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

Registered Care Manager

We are seeking a highly experienced, proactive, and dedicated Registered Care Ma...

Location

United Kingdom , Midlothian

Salary:

38417.44 - 46876.34 GBP / Year

Randstad

Expiration Date

July 31, 2026

Requirements

Elderly

Job Responsibility

Maintain and exceed Care Inspectorate standards, ensuring exceptional service delivery
Manage day-to-day operations, lead the staff team, and cultivate a supportive working environment
Build strong relationships with service users, families, local authorities, and healthcare professionals
Oversee staff recruitment, training, and professional development plans
Drive the strategic expansion of services across Edinburgh and Midlothian

What we offer

Excellent Growth Incentives
Clear Career Progression
additional expenses

Fulltime

Associate Center Director

POSITION SUMMARY Provide effective and efficient management, support the leader...

Location

United States , Oconto Falls

Salary:

Not provided

Encompass Early Educ & Care Inc

Expiration Date

Until further notice

Requirements

Bachelor’s Degree in Early Childhood Education or a combination of a Bachelor’s Degree in another field with 24 credits in early childhood education, child development, elementary education or early childhood special education, 9 credits in administration, leadership and management, or documents meeting an appropriate combination of relevant education and experience as defined by the National Association for the Education of Young Children (NAEYC)
Prior experience with High Scope or other play-based curriculum
Prior leadership experience in a NAEYC accredited environment preferred
General knowledge of the financial management aspects of a child care center
Demonstrated written and verbal communication skills, as well as time management and organizational skills
Solid working knowledge of Microsoft Office programs

Job Responsibility

Provide effective and efficient management, support the leadership and oversight of the child care center, contributing to the accomplishment of both Programming and Operations related Performance Objectives
Supervising, coaching, monitoring and planning for the professional development of the teaching staff, thus ensuring quality care and customer service for staff, children, families and community
Maintain knowledge of and ability to conduct family tours, process enrollments and assist with family account issues
Assure safety and upkeep of the center
Team with the Lead Center Director to ensure compliance with Encompass Policies, DCF, NAEYC, and High Scope curriculum
Support professional development and supervision of center staff, including conducting teacher observations
Ensure appropriate level of customer service is provided to children, families and staff
Provide support and backup for the responsibilities of the Lead Center Director
Perform the duties and responsibilities of a classroom teacher as needed
Support the Encompass mission, demonstrating professionalism and confidentiality in all encounters

Fulltime

Floating Child Care Teacher

POSITION SUMMARY: Utilizing the HighScope curriculum and related assessment and...

Location

United States , Green Bay

Salary:

Not provided

Encompass Early Educ & Care Inc

Expiration Date

Until further notice

Requirements

Supervise children by sight and sound to ensure safety, well-being, and emotional security
Ability to lower and rise from low chairs or the floor, reaching children quickly to ensure safety and support developmentally appropriate care
Ability to lift a minimum of 25 lbs. as needed
Relate professionally with children and adults through respectful, responsive, and ethical interactions aligned with NAEYC standards
Communicate professionally, respectfully, and confidentially with children, families, and colleagues
Meet physical examination and background check requirements per ethical and regulatory standards
Use classroom technology to enhance communication, record developmental progress, and support classroom responsibilities ethically and accurately
Maintain dependable attendance and flexibility to meet DCF teacher/child ratio requirements
Mobility and Stamina: Ability to stand, walk, kneel, and bend for extended periods. Must be able to move quickly in response to emergencies or child needs
Lifting and Carrying: Must be able to lift and carry children, supplies, and equipment, typically up to 30 pounds

Job Responsibility

Supervise children by sight and sound to ensure safety, well-being, and emotional security
Relate professionally with children and adults through respectful, responsive, and ethical interactions aligned with NAEYC standards
Communicate professionally, respectfully, and confidentially with children, families, and colleagues
Use classroom technology to enhance communication, record developmental progress, and support classroom responsibilities ethically and accurately
Maintain dependable attendance and flexibility to meet DCF teacher/child ratio requirements
Utilize the HighScope curriculum and related assessment and guidance philosophies, support children’s physical, social-emotional, and cognitive development while ensuring health, safety, and well-being
Responsibilities align with NAEYC Professional Standards and Code of Ethical Conduct, with a commitment to developmentally appropriate, culturally responsive, and inclusive practices
establish warm, nurturing relationships, recognize individual strengths, needs, cultures, and abilities, and promote each child’s sense of belonging, autonomy, and dignity
Through observation, documentation, and reflection, use assessment data to support learning and guide instructional decisions
In partnership with families, communicate respectfully and maintain confidentiality, recognizing families as essential partners

Fulltime

Training Specialist

We are looking for a Training Specialist to support a financial services organiz...

Location

United States , Moline

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

At least 5 years of experience in training, instructional delivery, or learning content development
Hands-on proficiency with Microsoft Word, PowerPoint, Teams, and Adobe editing tools
Demonstrated ability to design training materials and lead live instruction for business users
Confidence presenting to groups and communicating clearly in both virtual and in-person environments
Experience partnering with subject matter experts to turn technical or procedural guidance into effective training content
Strong writing skills with the ability to follow style guides and produce high-quality instructional materials

Job Responsibility

Participate in project discussions and vendor-led learning sessions to gain working knowledge of business systems and related processes
Create clear training materials, job aids, presentations, and print-ready learning resources that align with organizational standards
Collaborate with subject matter experts and stakeholders to identify department-specific learning needs and ensure content accuracy
Plan and organize training schedules, class logistics, and delivery strategies for audiences that may range from small groups to larger cross-functional teams
Facilitate live training sessions in virtual settings and, when needed, provide onsite instruction near key implementation milestones
Support the development of training tied to core banking platforms, teller tools, account opening applications, online banking solutions, document storage systems, and electronic signature platforms
Contribute to change impact conversations by helping employees understand new workflows, updated procedures, and operational expectations
Work with internal teams to maintain training plans, capture key topics, and prepare for future rollout phases and continued learning support

What we offer

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

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Senior Investigator - Fraud, Waste, and Abuse

Job Description

Job Responsibility

Requirements

What we offer

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