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

Vice President - Talent Acquisition

The Vice President of Talent acquisition leads the Center of Excellence and serv...

Location

United States , Hollywood

Salary:

Not provided

Memorial Healthcare System

Expiration Date

Until further notice

Requirements

Bachelors: Human Resources (Required)
Ten (10) years progressive leadership experience in Recruitment/Talent acquisition in a healthcare setting

Job Responsibility

Provide leadership and services focused on a highly engaged culture and team with direct oversight of talent activities such as: Employer brand alignment, sourcing, recruitment, selection, and pre-boarding and employee health
Develops, maintains and monitors key performance indicators (KPI's) in order to measure and report efficiency, service and productivity results to improve effectiveness of team, function, and organizational effectiveness
Serves as the subject matter expert and leader of the Center of Excellence to develop, design, and evaluate talent acquisition and workforce planning strategies for short-term and long-term talent solutions
Prepares, monitors, and evaluates departmental budgets, and ensures that the department operates in compliance with allocated funding
Provides continuous performance improvement of team members and process improvement initiatives to ensure the Memorial Experience is provided to all key stakeholders
Facilitates the development and maintenance of MHS Employer of Choice Branding Strategy to effectively attract top talent through strategic marketing initiatives and plans

Fulltime

Associate Mechanical Engineer – Data Center

Project Engineer – Performs commissioning of mechanical systems. Must be a self-...

Location

United States , Fredericksburg

Salary:

Not provided

Veolia

Expiration Date

Until further notice

Requirements

AE/BSc in Mechanical Engineering with less than one year with mission critical project experience
Minimum of 1 year of experience in commissioning with mission critical project experience, or relevant and applicable industry experience
Organized, detail-oriented, analytical, proactive, problem solver
Good communication and relationship skills
Effective written and verbal communication skills
Reliable performance and professional presentation
Ability to manage multiple tasks simultaneously
Be able to work well in a team environment
Ability to walk up to 5 miles per day
Carry up to 50 lbs

Job Responsibility

Commission mechanical, plumbing & fire alarm and suppression equipment and related controls, primarily in data center environments
Assist with preparing plans and procedures for execution of the commissioning process
Conduct commissioning activities from the design phase through the occupation phase, in accordance with client requirements and industry commissioning process best practices
Attend factory testing of equipment and document procedures and results
Conduct functional testing of equipment and measure results using test instrumentation
Fully document all field procedures including results, issues and observations either via company provided templates or online applications
Report on equipment & system performance
Assist with submitting and maintaining daily commissioning reports
Comply with company, client, and project safety requirements
Be willing and able to learn about Mechanical, Plumbing & FLS building systems & equipment

What we offer

Paid time off policies
Health, dental, vision, life insurance
Savings accounts
Tuition reimbursement
Paid volunteering
Employer sponsored 401(k) plan

Fulltime

Inventory Control Clerk

PPG is looking for a customer-focused individual to join the Refinish ColorIT Di...

Location

United States , Strongsville

Salary:

Not provided

PPG Industries

Expiration Date

Until further notice

Requirements

Three (3) years of proven experience in a shipping, logistics, inventory control, customer service, or supply chain environment
Microsoft Excel skills, including lookups, pivot tables, and conditional formulas
Oracle experience
Must be a U.S. Citizen

Job Responsibility

Frequent collaboration with Customer Service, ColorIT Helpdesk, and external vendors
Participate in monthly hardware planning meetings to maintain sales forecasts
Maintain target stocking levels by translating sales forecasts into POs for warehouse replenishment
Communicate with vendors regarding changes to sales forecasts, PO delivery dates, quality issues, and the like
Support inventory accuracy goals and goals through proper inventory transactions
Perform monthly cycle counts observing company requirements
Communicate with team members regarding stockouts, substitutions, and estimated available dates
100% shipping of customer orders
Cross-train to provide backup for other departmental functions (warehousing, shipping, computer bench)

Fulltime

Driver - Log Truck

Currently, we are seeking a qualified Log Truck Driver for our trucking division...

Location

United States , Quincy

Salary:

28.00 - 33.00 USD / Hour

Sierra Pacific Industries

Expiration Date

Until further notice

Requirements

Must have Class A license, current medical card, clean DMV record and good work references
1-year commercial truck driving experience

Job Responsibility

Drive log trucks in accordance with traffic laws
Load and secure log loads and transport to destination
Perform daily inspection of truck
Learn and operate onboard computerized time and load info tracking
Meet dispatch schedules on time
Perform duties in a safe and efficient manner

What we offer

Up to $1,500 hiring bonus
Excellent low-cost health benefits
Retirement plan with employer-paid contributions
Paid vacation and 10 holidays
Full Health Benefits Plan (medical, dental, vision) with low-cost premiums
401(k) with Company Match
additional Retirement Contributions
company-paid Life Insurance

Fulltime

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Senior Investigator - Fraud, Waste, and Abuse

Job Description

Job Responsibility

Requirements

What we offer

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