- UpvoteDownvoteShare Job
- Suggest Revision
Under the direction of the Chief Compliance & Privacy Office (CCO/CPO), this position leads the implementation and operations of the Health Plan's Compliance Program, including the HIPAA/Privacy and Anti-Fraud programs, in accordance with the Department of Managed Health Care (DMHC) and Department of Health Care Service (DHCS) laws and regulations.
ExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
Collaborate with IT management, the legal department, fraud department, human resources and law enforcement agencies to resolve security vulnerabilities or support investigations. Knowledge of Industry Security and Privacy Standards (e.g. HIPAA, PCI, GDPR, etc.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Plan, organize, and execute investigations or audits utilizing document review, witness interviews and data analysis to identify, evaluate and measure potential healthcare fraud and abuse to determine valid cases for appropriate action.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Supports the maintenance of the HIPAA/Privacy program, policies and procedures, audit and oversight activities, investigations, and reporting to the State regulatory agencies; Develops the annual Anti-Fraud Plan, oversees the fraud, waste, and abuse policies and procedures, investigations, and reporting to the State regulatory agencies.
ExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
Experience in fraud detection, prevention, or corporate financial crimes (Anti-Money Laundering and Fraud) investigations and regulatory filing - SAR, CAR, 314b, Hold Harmless, etc.
Full-timeExpandApply NowActive JobUpdated 18 days ago - UpvoteDownvoteShare Job
- Suggest Revision
As an Internal Audit Manager Sr., you will be within PNC's Internal Audit organization supporting Fraud under the Information Technology Audit team. Knowledge of laws, regulations and industry standards related to Technology and Security (such as GLBA, HIPAA, PCI, NIST, etc.
InternExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Provide legal representation and advice to healthcare clients in a broad range of litigation and transactional matters, including regulatory compliance, corporate transactions, fraud and abuse investigations, licensure and credentialing, and risk management.
Full-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
- Suggest Revision
Certified Compliance and Ethics Professional (CCEP), Certified in Healthcare Compliance (CHC), Certified in Healthcare Privacy Compliance (CHPC), Certified Fraud Examiner (CFE), or other compliance related certification preferred.
ExpandUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Knowledge of current and evolving fraud threats, tactics, and techniques in the banking and financial services industry. Experience identifying Security and Fraud risks impacting a global organization.
InternExpandUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Knowledge of anti-money laundering and sanctions activities in banking and financial services industry. Managing Risk - Assessing and effectively managing all of the risks associated with their business objectives and activities to ensure they adhere to and support PNC's Enterprise Risk Management Framework.
InternExpandUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Using cutting edge technology, you would participate in a collaborative setting and help guide PNC's Internal Audit department into the future. Preferred locations include Pittsburgh, PA, Birmingham, AL, Raleigh, NC, or Cleveland, OH. Responsibilities require time in the office or in the field on a regular basis.
InternExpandUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Problem Management Process - Knowledge of and ability to bring a reported problem to successful resolution. Performs detailed and general reviews of internal audit work paper documentation. PNC's Internal Audit department is composed of industry leaders who provide independent, objective assurance and consulting services designed to add value and recommend improvement to the organization's operations.
InternExpandUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
Coordinates procedures and reviews work papers supporting audit of internal controls, business processes, and account balances. Relationship Management - Ability to establish and build healthy working relations and partnerships with clients, vendors, and peers.
InternExpandUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Makes recommendations regarding the deployment of team resources and performs talent management activities. Written Communications - Knowledge of written communications issues and ability to produce a variety of business documents that demonstrate command of language, clarity of thought, and orderliness of presentation.
InternExpandUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
5+ years' experience in a managed care healthcare setting with experience in Compliance, HIPAA/Privacy, FWA and/or Regulatory Affairs operations. Reports investigations routinely to the CCO/CPO and quarterly to the Compliance & Delegation Oversight Committees.
RemoteExpandUpdated 3 days ago
hipaa investigations fraud jobs
FEATURED BLOG POSTS
How to Effectively Recruit Employees
Today, hiring and retaining talent looks much different than it did only two or three years ago. Financial instability and the strain on our mental health brought on by the pandemic has made everyone more wary and selective of their workplace and employer. Whereas in the past people might have prioritized promotions and financial reward, today they look at other factors such as workplace flexibility, personal fulfillment and values alignment.
How Many Hours is Part-Time vs. Full-Time Work?
Growing up you watched your parents shuffle to and from the office, held hostage to their 9 to 5. If jammed-packed schedules and deadlines sound frightening, you might consider pivoting your search to part-time jobs. In fact, even employers have shifted their preference, selecting more people open to the idea of flexible working hours.
How to Make a Job Offer More Competitive
Money alone makes it hard to attract and retain top-notch candidates, especially when you are competing with larger businesses and corporations in your industry. So, instead of focusing on money, figure out how to make a job offer more competitive when you can't offer more money.
5 Ways to Stretch Your Hiring Budget
Many businesses across the country have adjusted business operations to make it through the pandemic. After a period of hardship, many business owners, like yourself, are ready to start recruiting and rebuilding a bigger, more skilled workforce - only now you have to do it with a smaller hiring budget.
How to Ask for a Raise at Work
Here we go again; it’s time to talk money. Whether you’re one year in at a new company or approaching year five on the same team, learning how to ask for a raise should be part of your long-term career plan. These conversations are rarely fun (thanks to society, which has conditioned us to believe that money is taboo), but they are necessary if you want to, well, get paid what you’re worth. Trust us, there’s a lot of money on the table for taking. Below, we’ll discuss tips on timing, approach, and follow-up.
How to Maximize Action Verbs in Your Resume
Writing a resume that stands out takes more than using keywords and savvy formatting. It’s not just about having an impressive list of accomplishments. It’s also about how you position them using action verbs and deliberate word choice. So if you are looking for a way to craft a resume that stands out and gets calls back? Start by sprucing up your resume with captivating action verbs.
What is Your Desired Job Title?
You’ve decided to look for a new job. So now comes the question — what is your desired job title? There are lots of considerations to think through when deciding on the right title for your next role.