Healthcare Fraud Investigator
Location
California
Posted
19 hours ago
Salary
$85K - $105K / year
Seniority
Senior
Job Description
Healthcare Fraud Investigator
Contact Government Services
Healthcare Fraud Investigator Los Angeles, CA / Remote / Hybrid / San Francisco, CA Litigation Support / Full Time Hybrid / Hybrid Healthcare Fraud Investigator Employment Type: Full-Time, Mid-Level Department: Litigation Support CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project in Nashville, TN. The candidate must take the initiative to ask questions to successfully complete tasks, perform detailed work consistently, accurately, and under pressure, and be enthusiastic about learning and applying knowledge to provide excellent litigation support to the client. CGS brings motivated, highly skilled, and creative people together to solve the government’s most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities. Responsibilities will Include: - Review, sort, and analyze data using computer software programs such as Microsoft Excel. - Review financial records, complex legal and regulatory documents and summarize contents, and conduct research as needed. Preparing spreadsheets of financial transactions (e.g., check spreads, etc.). - Develop HCF case referrals including, but not limited to: - Ensure that HCF referrals meet agency and USAO standards for litigation. - Analyze data for evidence of fraud, waste and abuse. - Review and evaluate referrals to determine the need for additional information and evidence, and plan comprehensive approach to obtain this information and evidence. - Advise the HCF attorney(s) regarding the merits and weaknesses of HCF referrals based upon applicable law, evidence of liability and damages, and potential defenses, and recommend for or against commencement of judicial proceedings. - Assist the USAO develop new referrals by ensuring a good working relationship with client agencies and the public, and by assisting in HCF training for federal, state and local agencies, preparing informational literature, etc. - Assist conducting witness interviews and preparing written summaries. Qualifications: - Four (4) year undergraduate degree or higher in criminal justice, finance, project management, or other related field. - Minimum three (3) years of professional work experience in healthcare, fraud, or other related investigative field of work. - Proficiency in Microsoft Office applications including Outlook, Word, Excel, PowerPoint, etc. - Proficiency in analyzing data that would assist in providing specific case support to the Government in civil HCF matters (E.g., Medicare data, Medicaid data, outlier data). - Communication skills: Ability to interact professionally and effectively with all levels of staff including AUSAs, support staff, client agencies, debtors, debtor attorneys and their staff, court personnel, business executives, witnesses, and the public. Communication requires tact and diplomacy. - U.S. Citizenship and ability to obtain adjudication for the requisite background investigation. - Experience and expertise in performing the requisite services in Section 3. - Must be a US Citizen. - Must be able to obtain a favorably adjudicated Public Trust Clearance. Preferred qualifications: - Relevant Healthcare Fraud experience including compliance, auditing duties, and other duties in Section 3. - Relevant experience working with a federal or state legal or law enforcement entity. #CJ $85,000 - $105,000 a year
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Role Description The One Medical Virtual Medical Team (VMT) is a leading provider of virtual clinical care, providing world-class, convenient, evidence-based virtual medical care to One Medical patients in concert with their primary care providers. Through advanced technology and a team-based approach, we care for patients 24 hours a day, 365 days a year. Our team is united by intellectual curiosity, inclusiveness, and a powerful mission: transforming healthcare and bringing world-class primary care to everyone. What you’ll be working on: - Treating patients via tele-health visits, including telephonic triage calls, video visit appointments, and email follow-ups - Continuous learning during weekly Clinical Rounds and through other modalities - Ongoing collaboration with both virtual and in-office teammates via daily huddles - Utilization of your specific clinical training and opportunities to give exceptional care to patients virtually Qualifications - Completion of Master’s Degree in an accredited physician assistant program (MSPAS) and is maintaining an active NCCPA certification - Currently licensed in CA, NY, or DC with the ability to obtain additional state licenses as needed - In the past 5 years, practiced as a PA: - 4 years in an outpatient primary care setting seeing patients of all ages (0+), OR - 4 years in an urgent care or emergency medicine setting seeing patients of all ages (0+) - Ability to work overnights (current shifts range from 7pm-7am) - Ability to work weekday and weekend shifts - Excellent clinical and communication skills Requirements - A passion for human-centered primary care - The ability to successfully communicate with and provide care to individuals of all backgrounds - The ability to effectively use technology to deliver high quality care - Clinical proficiency in evidence-based primary care - The desire to be an integral part of a team dedicated to changing healthcare delivery - An openness to feedback and reflection to gain productive insight into strengths and weaknesses - The ability to confidently navigate uncertain situations with both patients and colleagues - Readiness to adapt personal and interpersonal behavior to meet the needs of our patients Benefits - Paid sabbatical for every five years of service - Free One Medical memberships for yourself, your friends and family - Employee Assistance Program - Free confidential services for team members who need help with stress, anxiety, financial planning, and legal issues - Competitive Medical, Dental and Vision plans - Pre-Tax commuter benefits - PTO cash outs - Option to cash out up to 40 accrued hours per year - 401K match - Credit towards emergency childcare - Company paid maternity and paternity leave - Paid Life Insurance - One Medical pays 100% of the cost of Basic Life Insurance - Disability insurance - One Medical pays 100% of the cost of Short Term and Long Term Disability Insurance - Malpractice Insurance - Malpractice fees to insure your practice at One Medical is covered 100% - UpToDate Subscription - An evidence-based clinical research tool - Continuing Medical Education (CME) - Receive an annual stipend for continuing medical education - Rounds - Providers end patient care one hour early each week to participate in this shared learning experience - Discounted rate to attend One Medical’s Annual REAL primary care conference
Inpatient - Outpatient Dietitian
Compass GroupFounded in 1941, Compass Group is a multinational corporation and the world’s largest provider of contract foodservice and support services. Headquartered in
Title: INPATIENT/OUTPATIENT DIETITIAN - HRLY OXFORD, MS Location: Oxford, MS, United States PRN/Per Diem Job Description: Morrison Healthcare Take the next step in your career with Morrison Healthcare in Oxford, MS! Location: Morrison Healthcare at Baptist Memorial Hospital, North Mississippi Setting: Inpatient / Outpatient Schedule: PRN/Per Diem availability with flexible scheduling. Available weekends, holidays, and Monday-Friday for vacation coverage and to support business needs as required. Requirement: Must be registered with the Commission on Dietetic Registration. New Grads Welcome! Mississippi State Licensure or Provisional Licensure is required. Position Details: Provide individualized nutrition assessment, intervention, and education to inpatient populations while collaborating with the interdisciplinary care team. Why Oxford, MS: Oxford, MS, offers a unique blend of small-town charm, cultural attractions, and a vibrant community atmosphere. It is known for its thriving food scene, historic downtown square, and welcoming community. We go the extra mile for our Dietitians with perks designed to support education, career growth, and professional success! Special perks include: - Career Advancement-Growth programs tailored to RDNs - Free CEUs-Through our nutrition education webinar series Why Choose a Career as a Compass Group Dietitian? Compass Group employs over 3,000 RDNs across the United States, making us one of the nation's largest employers of Dietitians in a variety of settings: - Hospitals and healthcare systems - Senior living communities - Schools and universities - Corporate wellness programs - Food service operations We offer unmatched opportunities for professional growth: - Specialization - Leadership development - Cross-functional career paths The company has earned significant recognition, including being named one of Modern Healthcare's "Top 100 Best Places to Work in Healthcare" for five consecutive years, and appearing on Training Magazine's Top 125 Organizations list for six straight years. Job Summary Make a real impact as a Clinical Dietitian! You'll provide Medical Nutrition Therapy and education in an acute care setting, working with a collaborative team to enhance patient outcomes through evidence-based nutrition care. What You'll Do: - Clinical Nutrition Care: Perform comprehensive nutritional assessments and develop individualized care plans to promote recovery and improve health outcomes - Education: Provide guidance on nutrition and lifestyle strategies to support sustainable, long-term wellness to patients, families, staff, and the community - Evidence-Based Practice: Apply the latest research in alignment with the diet manual, company policies, and facility protocols to ensure high-quality, consistent care - Quality & Performance Improvement: Contribute to QAPI initiatives aimed at advancing patient care and clinical excellence - Collaboration & Service Excellence: Partner with the food service management team to help achieve patient satisfaction and service goals - Mentorship & Professional Development: Support the growth of staff and dietetic interns through education and training as applicable What We're Looking For: - Registered Dietitian Nutritionist (RDN) or CDR exam eligible - Licensed Dietitian (or willing to obtain) in the state of practice as applicable - Healthcare experience preferred; new graduates with strong clinical training are encouraged to apply Why You'll Love Working Here: - You'll be part of an environment where your ideas are welcomed, and your growth is encouraged - You'll have access to ongoing education, resources, development, and advancement opportunities to support your career path - You'll have the autonomy to apply your clinical judgment while still having guidance when you need it Apply to Compass Group today! Associates may be eligible for additional paid and/or unpaid time off benefits in accordance with applicable federal, state, and local laws. For positions in Washington State, Maryland, or to be performed remotely, copy/paste the link below for paid time off benefits information. https://www.compass-usa.com/wp-content/uploads/2023/08/2023_WageTransparency_MorrisonHealthcare.pdf Compass Group is an equal opportunity employer. At Compass, we are committed to treating all Applicants and Associates fairly based on their abilities, achievements, and experience without regard to race, national origin, sex, age, disability, veteran status, sexual orientation, gender identity, or any other classification protected by law. Qualified candidates must be able to perform the essential functions of this position satisfactorily with or without a reasonable accommodation. Disclaimer: this job post is not necessarily an exhaustive list of all essential responsibilities, skills, tasks, or requirements associated with this position. While this is intended to be an accurate reflection of the position posted, the Company reserves the right to modify or change the essential functions of the job based on business necessity. We will consider for employment all qualified applicants, including those with a criminal history (including relevant driving history), in a manner consistent with all applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, and the New York Fair Chance Act. We encourage applicants with a criminal history (and driving history) to apply. Applications are accepted on an ongoing basis. Compass Group maintains a drug-free workplace.
Nurse Coordinator - Heart & Vascular
BJC HealthCareBJC HealthCare is one of the largest healthcare organizations in the U.S. focused on delivering "the world's best medicine," made better by its 30,000+ clinical
Role Description As part of the Heart and Vascular Administration team, the Clinical Nurse Coordinator ensures accurate, complete, and timely submission of clinical data to national cardiovascular registries (NCDR and VQI). This role plays a key part in performance monitoring and quality improvement initiatives within the heart and vascular service line. This is an excellent opportunity to provide patient impact through quality improvement. - Review electronic medical records to extract, validate, and submit data to national registries (NCDR, VQI). - Support supervisor, management, and performance improvement teams on quality and data projects. - Train and mentor new and existing abstraction staff; provide ongoing updates on evolving registry guidelines. - Serve as subject matter expert for abstraction processes, including inclusion/exclusion criteria, validation rules, and submission timelines. - Conduct inter-rater reliability and quality audits to ensure data accuracy and regulatory compliance. - Maintain current knowledge of abstraction standards from CMS, The Joint Commission, and AHA Get With The Guidelines, programs. - Daily interaction with Excel, EPIC, Metric reporting and presentations. - Prior experience with NCDR, VQI or similar national registries is a plus! - Prior experience with cardiovascular, vascular, or operating room nursing is preferred. Qualifications - Nursing Diploma/Associate's in Nursing. - 2-5 years of experience. - No supervisor experience required. - RN license. Requirements - Bachelor's Degree in Nursing preferred. Benefits - Comprehensive medical, dental, vision, life insurance, and legal services available first day of the month after hire date. - Disability insurance paid for by BJC. - Annual 4% BJC Automatic Retirement Contribution. - 401(k) plan with BJC match. - Tuition Assistance available on first day. - BJC Institute for Learning and Development. - Health Care and Dependent Care Flexible Spending Accounts. - Paid Time Off benefit combines vacation, sick days, holidays and personal time. - Adoption assistance.
Information & Referral Specialist
VIA VISUALLY IMPAIRED ADVANCEMENTVIA is an Affirmative Action/Equal Opportunity Employer. Women, minorities, veterans, and individuals with disabilities are encouraged to apply. Any person with a disability needing special accommodations to the application process please call Human Resources.
Role Description VIA is seeking Information & Referral Specialists who are interested in working between 16 and 30 hours per week and have availability to support afternoon, evening and/or overnight scheduling needs. This position works in a remote capacity and is primarily responsible for answering calls, determining and addressing caller needs while collecting and documenting all required data. Applicants will be expected to maintain flexibility in scheduling to the extent practical to support the needs of our 24-hour/7 day a week call center operations. Essential Functions: - Answer and document all incoming calls in accordance with Contact Center procedure - Manage call volume in a timely and efficient manner - Assess caller needs to provide comprehensive information and make accurate referrals to appropriate agencies, programs and services - Schedule appointments for agency programs and collect necessary caller information - Complete follow ups and log calls in accordance with Contact Center procedure - Uphold quality assurance goals Competencies: - Proficient in the use of Microsoft Office Suite - Demonstrate excellent internal and external customer service - Effectively work with individuals of diverse backgrounds - Comfortable communicating with individuals in crisis or experiencing high levels of stress - Counsel individuals with an ability to balance agency policy while displaying sensitivity to clients/colleagues - Adapt communication style depending on assigned duty - Maintain confidentiality and professionalism in a fast-paced environment - Demonstrate independent thinking and problem solving - Demonstrate detail orientation in completion of duties - Demonstrate patience, flexibility, and active listening - Effectively communicate with colleagues, customers, vendors and/or outside agencies - Achieve results independently and work well as part of a team - Maintain a calm, sensitive demeanor in an actively changing work environment Qualifications - High School diploma or equivalent - Two years of experience in customer service, Contact Center or human services - Must live in one of the following states: New York, Pennsylvania, North Carolina, South Carolina - Ability to provide documentation of legal blindness preferred but not required Company Description VIA is an Affirmative Action/Equal Opportunity Employer. Women, minorities, veterans, and individuals with disabilities are encouraged to apply. Any person with a disability needing special accommodations to the application process please call Human Resources.
