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

Manager

We are looking for an organized and proactive Manager or Supervisor who will han...

Location

United States , Aiea

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

At least 2 years of experience in office administration, with added value from backgrounds in human resources, healthcare administration, or practice operations
Demonstrated ability to develop or manage policies, forms, procedures, documentation, or training materials
Strong organizational skills with the ability to handle multiple priorities independently and with a high level of accuracy
Clear written and verbal communication skills paired with a detail-oriented and service-oriented approach
Working knowledge of Google Workspace, including Docs, Sheets, and Drive
Experience supporting onboarding, employee documentation, compliance practices, or staff relations is preferred
Familiarity with medical or healthcare office workflows, billing processes, scheduling, or patient-facing operations is preferred
Previous experience training, mentoring, or supervising team members is preferred

Job Responsibility

Create and update internal HR documents, operational procedures, employee forms, and standard workflows to support consistency and compliance
Help maintain onboarding resources, handbook content, and staff training materials while keeping personnel files and training records accurate and secure
Build efficient office processes, track follow-up items, and support scheduling and administrative coordination across daily operations
Guide and support front desk team members through coaching, training, and quality oversight to promote excellent service and dependable execution
Monitor patient-facing administrative activities to ensure smooth arrival and departure experiences, and step in to assist front or back office coverage when needed
Support billing-related tasks such as insurance coordination, payment processing, and workflow improvements that strengthen revenue cycle operations
Assist with resolving issues involving payment tools, practice software, and vendor-supported systems to improve reliability and efficiency
Prepare reports, maintain business records in Google Workspace, and provide general administrative support including supply and inventory coordination

What we offer

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

New

Ao3 Administration Officer

Randstad are proud to currently be partnering with a large State Government Depa...

Location

Australia , Brisbane

Salary:

51.12 AUD / Hour

Randstad

Expiration Date

July 30, 2026

Requirements

Experience working effectively within a collaborative team environment
extremely high level of attention to detail and strong critical thinking skills
ability to use judgment and problem-solving skills under minimal supervision to manage competing priorities
knowledge of ArcGIS or other GIS software is highly regarded
analytical skills, the ability to interpret, review, edit, and collate numerical and written system data
excellent communication and customer service skills for engaging with stakeholders and the public
reliable, adaptable, and capable of managing confidential and sensitive departmental information
a current unrestricted 'C' class drivers’ licence
practical experience or qualifications in a related field will be favourably regarded

Job Responsibility

Providing timely and accurate administrative support, including completing internal quality assurance measures and delivering documentation
utilising ArcGIS and other systems/applications to produce outputs for aerial and ground jobs, including generating maps and related deliverables
monitoring and editing data for accuracy, maintaining electronic and hard-copy records, and raising data issues to ensure data integrity
using judgment and problem-solving skills when undertaking allocated tasks and non-routine requests to meet tight timeframes
exporting, reviewing, collating, and ordering data reports to be escalated to management for decision-making purposes
performing administrative support for treatment or surveillance activities, including generating appointments and bookings
providing high-quality customer service by responding to enquiries and accurately recording details on relevant databases
supporting the team by providing mentoring and training to new or inexperienced staff
participating in user acceptance testing, troubleshooting, and providing feedback for system upgrades
participating in the continual improvement of operational processes and identifying procedural inconsistencies

What we offer

Competitive hourly rate + super
Primary Berrinba location, transitioning to excellent hybrid options (up to 2 days working from home or utilising secondary depots across Ipswich, Logan, Moreton Bay, Brisbane, or the Gold Coast) after an initial 3-month training period
learn specialist skills and knowledge in GIS mapping software and large-scale government program operations
discounts at retailers like David Jones, Myer & JB HiFi, Rebel Sport, Woolworths, Hoyts cinemas and many more
a free Employee Assistance Program
access to your payslips at the click of a button via our MyRandstad App
a weekly pay cycle

Fulltime

New

Pharmacist - Full Time

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

Location

United States , Stillwater

Salary:

60.00 - 73.00 USD / Hour

CVS Health

Expiration Date

September 30, 2026

Requirements

Bachelor of Science in Pharmacy or Pharm. D. degree
Active Pharmacy License in the state in which you are employed
Not on the DEA Excluded Parties List
Immunization Certification through an accredited organization (e.g., APhA)
No pending felony charges or convictions for criminal offenses involving controlled substances

Job Responsibility

Supporting the Pharmacy Manager in leading and directing Pharmacy Technician Support Staff
Accountable for supporting the management, oversight and operation of all aspects within your pharmacy including Patient Safety
Pharmacy Professional Practice
Regulatory Requirements
Quality Assurance
Customer Service
Personnel Management
Inventory Management
Financial Profitability
Loss Prevention

What we offer

Medical, dental, and vision coverage
Paid time off
Retirement savings options
Wellness programs
Eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range

Fulltime

New

Pharmacy Technician

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

Location

United States , Pelham

Salary:

16.00 - 24.00 USD / Hour

CVS Health

Expiration Date

August 29, 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
State-level licensure and national certification requirements vary by state, click here to learn more.

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

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

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