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

Payroll/Absence/Time Tracking Functional Consultant - Workday Success Plans

We are seeking people who love to help customers overcome HR technology challeng...

Location

Costa Rica

Salary:

Not provided

Workday

Expiration Date

Until further notice

Requirements

3 + years of Human Capital Management software support or consulting experience on medium or large enterprise HRIS projects, or applicable practitioner deployment experience
3 + years of experience with the following product areas: Payroll, Absence, Time Tracking supporting US and/or Canada
3+ years of Workday Consulting experience or experience as a Workday SME
Demonstrates a solid grasp of HR related systems and processes
Certified or ability to certify in Workday HCM products and to effectively deploy the solutions
Experience with influencing, interacting and collaborating with senior leaders, internally and externally
Capable of leading and influencing design meetings toward an effective and collaborative outcome
Ability to deliver and get results while managing to a project plan
Excellent verbal and written communication skills
The ability to work on multiple engagements simultaneously

Job Responsibility

Confidently and consistently provide excellent customer service
Engage customers to quickly understand business requirements
Share their broad experience with industry practices
Adapt and succeed independently in challenging situations
Develop and demonstrate system configuration solutions, articulating product capabilities, plus the benefits and risks of design decisions
Support multiple customers concurrently on short duration projects
Enjoy the reward of helping customers to be more self-sufficient, to stabilize and optimize their Workday applications and to learn about new features
Find that the highly collaborative nature of this team helps them to be productive and to demonstrate their strengths every day
Share expertise with customers on a variety of Ask-an-Expert requests by conducting research, delivering small scope consulting, troubleshooting product configuration, and clearly communicating responses
Partner with an Engagement Manager to deliver services including Feature Adoption Workshops, Functional Review, Health Check

Fulltime

Deskside Support Engineer

The Deskside Support Engineer role involves on-site and remote support for deskt...

Location

China , Shenzhen

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

4-6 years of relevant experience
Strong knowledge of Windows operating system environment
Solid customer interaction skills
A+ desktop or equivalent skill set is required
additional certifications for various hardware platforms may be required

Job Responsibility

Troubleshoots operational quality desktops, notebooks, printers, and associated peripherals
Installs, maintains and optimizes desktop/notebook configurations at customer sites
Diagnoses and resolves product performance problems
Performs maintenance and repair services
Ensures customer satisfaction by advising customers on preventive maintenance and configurations which may impact product performance
Instructs customers in the operation and maintenance of the system
Performs troubleshooting, parts replacement, system upgrades, basic deployment, and repair on desktops/notebooks/printers
Identifies potential issues that could adversely impact end user experience and takes corrective action
May respond to calls after normal business hours per leader instructions
Travel is required

Fulltime

Team Member

Are you ready to bring energy, serve up smiles, and be part of something excitin...

Location

United Kingdom , Worcester

Salary:

8.00 - 12.71 GBP / Hour

360 Resourcing Solutions

Expiration Date

Until further notice

Requirements

A positive attitude and a passion for making people's day
A team player who brings energy and enthusiasm
No experience needed—we'll teach you everything!

Job Responsibility

Serve our famous shatter crunch chicken with energy and pride
Deliver unforgettable guest experiences every shift
Master different stations with full training provided
Be part of a supportive, fun-loving team

What we offer

Flexible scheduling
Free chicken on shift + 30% off when you're not working
Paid day off on your birthday
Clear career progression opportunities
28 days holiday (pro rata)
Access up to 30% of your pay early with Wage Stream
Enhanced parental leave
Pension contributions
Gym and cycle-to-work discounts
Tech scheme & online perks platform

Fulltime

Account Executive, Business Team Sales

The Account Executive, Business Team Sales role at T-Mobile is designed for ambi...

Location

United States , Charlotte

Salary:

43020.00 - 77700.00 USD / Year

T-Mobile

Expiration Date

Until further notice

Requirements

High School Diploma/GED (Required)
1+ years verifiable new customer acquisition sales experience, preferably within a commissioned environment. (Preferred)
Outside B2B sales experience. (Preferred)
At least 18 years of age
Legally authorized to work in the United States
Task Management: Ability to work well in a dynamic, fast changing environment that requires a high degree of multi-tasking. (Required)
Customer Service: Demonstrated experience delivering superior customer service and attention to detail. (Required)
Communication: Excellent interpersonal, written, and oral communication skills. (Required)
Negotiation: Effective negotiating and closing skills, including communication, emotional intelligence, and problem-solving. (Required)

Job Responsibility

Generate and work leads in developed and underdeveloped territories through prospecting, cold calling, and networking under sales manager supervision
Sell to demonstrate T-Mobile's value, recommend wireless solutions including price plans, data services, handsets, and accessories
Negotiate and close deals
Develop skills in prospecting, call execution, and relationship management with leadership
Participate in product training and sales meetings
Create effective sales approaches, solutions, and proposals
Utilize sales force automation, manage sales funnel, and report on sales activities and forecasts

What we offer

Competitive base salary and compensation package
Annual stock grant
Employee stock purchase plan
401(k)
Free, year-round money coaches
Medical, dental and vision insurance
Flexible spending account
Paid time off
Up to 12 paid holidays
Paid parental and family leave

Fulltime

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Senior Investigator - Fraud, Waste, and Abuse

Job Description

Job Responsibility

Requirements

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