Registered Nurse – Nursing Home Surveyor/Complaint Investigator Greenlife Healthcare StaffingRegistered Nurse – Nursing Home Surveyor/Complaint InvestigatorNew York, New York$60Minimum 2 years of experience in utilization review, claims adjudication, medical review, fraud investigation, surveillance, or monitoring activities; OR 3 years of clinical or administrative experience; OR a Bachelor's degree in Nursing and 2 years of clinical or administrative experience. Position Overview: We are seeking a dedicated and experienced Registered Nurse – Nursing Home Surveyor / Complaint Investigator to join our team across New York City (Bronx, Kings, Richmond, Manhattan, and Queens).
EEO Investigator Atria ConsultingEEO InvestigatorNew York, NY$55–$60 / hourWhen determining a team member's base salary and/or hourly rate, various factors may be taken into account as applicable (such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity). Candidates must be comfortable working in a fast-paced healthcare environment and traveling to various facilities throughout New York City as needed.
Surveillance Investigator Allied UniversalSurveillance InvestigatorWhite Plains, New York$25–$28 / hourThe Surveillance Investigator will perform discreet mobile and stationary surveillance of a Claimant to confirm current activities and capabilities to assist with the administration of an insurance claim. Conduct independent investigations of insurance claims across a range of coverage types, including workers’ compensation, general liability, property and casualty, and disability .
Surveillance Investigator - Bronx Allied UniversalSurveillance Investigator - BronxThe Bronx, New York$25–$28 / hourThe Surveillance Investigator will perform discreet mobile and stationary surveillance of a Claimant to confirm current activities and capabilities to assist with the administration of an insurance claim. Conduct independent investigations of insurance claims across a range of coverage types, including workers’ compensation, general liability, property and casualty, and disability .
NewSurveillance Investigator - Staten Island Allied UniversalSurveillance Investigator - Staten IslandStaten Island, NY$25–$28 / hourThe Surveillance Investigator will perform discreet mobile and stationary surveillance of a Claimant to confirm current activities and capabilities to assist with the administration of an insurance claim. RESPONSIBILITIES: Conduct independent investigations of insurance claims across a range of coverage types, including workers' compensation, general liability, property and casualty, and disability.
Surveillance Investigator - Brooklyn Allied UniversalSurveillance Investigator - BrooklynBrooklyn, New York$25–$28 / hourThe Surveillance Investigator will perform discreet mobile and stationary surveillance of a Claimant to confirm current activities and capabilities to assist with the administration of an insurance claim. Conduct independent investigations of insurance claims across a range of coverage types, including workers’ compensation, general liability, property and casualty, and disability .
Principal Financial Investigator Manhattan District Attorney's OfficePrincipal Financial InvestigatorNew York, NY$100,786–$114,387 / yearThe Office's Professional Staff perform a variety of key functions, including supporting the Trial Division, Investigation Division, Special Victims Division, Pathways to Public Safety Division, and Appeals Division, which handles all the Office's matters in state and federal appellate courts. Minimum Qualification Requirements: A baccalaureate degree from an accredited college or university, with a major in accounting and eight (8) years of satisfactory diversified accounting and auditing experience, at least two (2) years of which must have been in the supervision of staff engaged in fiscal or accounting investigations; or.
Forensic Accountant Investigator Manhattan District Attorney's OfficeForensic Accountant InvestigatorNew York, NY$108,601–$122,456 / yearThe Office's Professional Staff perform a variety of key functions, including supporting the Trial Division, Investigation Division, Special Victims Division, Pathways to Public Safety Division, and Appeals Division, which handles all the Office's matters in state and federal appellate courts. Minimum Qualification Requirements: A baccalaureate degree from an accredited college or university, with a major in accounting and eight (8) years of satisfactory diversified accounting and auditing experience, at least two (2) years of which must have been in the supervision of staff engaged in fiscal or accounting investigations; or.
Affirmative Civil Enforcement ACE Investigator Contact Government Services LLCAffirmative Civil Enforcement ACE InvestigatorNew York, NYPerforms sophisticated analyses of large-scale hard-copy and electronic data such as health care claims data, financial transaction data, accounting records, or bank records to develop investigative leads and to determine their potential relevance to the allegations at issue. • Performs analysis to clarify the target suspects or organizations pattern of operations to identify information relevant to the legal issues involved and to recommend valuable approaches to the AUSAs or other members of the investigative team.
Claims Investigator GallagherClaims InvestigatorFairfield, New JerseyRemoteFull timeSocial Profiling Online Tracking) report provides a detailed snapshot including identification, address history, relatives, DMV (state dependent), litigation records, property ownership, felony criminal history, business affiliations, professional licenses and ever-changing social media. Conducts basic to moderately complex claim investigations to collect information and often compile a comprehensive profile of a claimant for use in defense strategy and further potential investigation.
Construction Field Investigator GallagherConstruction Field InvestigatorPleasantville, New York$28–$35 / hourFull timeAs a Construction Field Investigator, you will conduct on-site investigations, gather and analyze evidence, interview witnesses, document accident scenes, and prepare detailed reports that help clients determine the facts surrounding construction incidents and claims. Unlike traditional investigator positions, this role provides the opportunity to develop expertise in construction-related claims and losses while supporting some of the nation's largest contractors, insurance carriers, and risk management programs.
Geriatrician - Principal Investigator Pinnacle Clinical ResearchGeriatrician - Principal InvestigatorRidgewood, New JerseyTo do this, they agree that the research: oIs conducted in accordance with all federal regulatory requirements, state law, and Pinnacle Clinical Research policies (including SOPs) oIs conducted in accordance with the IRB-approved plan oThey will ensure the accuracy, security, and integrity of the research data and the subsequent analysis of that data. Ideal candidates will have significant experience in caring for patients with Alzheimer’s dementia and steatotic liver disease with strong analytical skills, and a dedication to advancing clinical research through high-quality patient care and ethical study practices.
Auditor/Investigator II Qlarant Quality Solutions IncAuditor/Investigator IINJCollects data for audits/investigations into claims, utilizing a combination of analytical skills and attention to detail, reviewing documentation, interviewing involved parties, and communicating with various stakeholders to gather relevant information for successful resolution and closure. Essential Functions: Conducts routine and impartial audits/investigations from start to closure into customer claims, ensuring accurate and fair assessments of claims validity.
Senior Compliance Investigator Centene Corporation GroupSenior Compliance InvestigatorNY$70,100–$126,200 / yearLeads and conducts compliance and ethics investigations across all business units and health plans, including but not limited to assessment of allegations, review of relevant documents, witness interviews, analysis of facts, root cause analysis, and preparation of investigation reports with recommended remedial or disciplinary actions. Education/Experience: A Bachelor's Degree in Related Field or Associates with 5 years of applicable experience, or a High School/GED with 6 years of applicable experience may substitute for the Bachelor's Degree, required.
SIU Investigator Centene Corporation GroupSIU InvestigatorNY$56,200–$101,000 / year5+ years in healthcare field working in fraud, waste and abuse investigations and audits, (or) 5+ years of insurance claims investigation experience or professional investigation experience with law enforcement agencies, (or) 7+ years of professional investigation experience involving economic or insurance related matters. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse.
Healthcare Fraud Investigator Contact Government Services LLCHealthcare Fraud InvestigatorNew York, NY$85,000–$105,000 / yearCommunication 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. 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.
Senior Investigator Lead Validation (Healthcare FWA) Cotiviti Holdings Inc.Senior Investigator Lead Validation (Healthcare FWA)NYRemote$70,000–$90,000 / yearLeverages claims data, dashboards, and predictive models to identify providers exhibiting atypical billing patterns or potential fraud, waste, and abuse. Overview As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis (a high level of proficiency with Excel is required).
Healthcare Fraud Investigator CONTACT GOVERNMENT SERVICESHealthcare Fraud InvestigatorNew York, NY$85,000–$105,000 / yearCommunication 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. 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.
Affirmative Civil Enforcement (Ace) Investigator CONTACT GOVERNMENT SERVICESAffirmative Civil Enforcement (Ace) InvestigatorNew York, NY$51,435.30–$66,131.10 / yearPerforms sophisticated analyses of large-scale hard-copy and electronic data, such as health care claims data, financial transaction data, accounting records, or bank records to develop investigative leads and to determine their potential relevance to the allegations at issue. Skills and attributes for success: The investigator will generate new investigations, and to continue with ongoing investigation and civil actions involving fraud in areas such as healthcare, contracting, and grants, as well as other fraud and abuse of federal public funds and programs.
Asset Protection Investigator Saks Fifth AvenueAsset Protection InvestigatorNew York City, New York$23.58–$29.47 / hourUnder direction from the Asset Protection Manager or Assistant General Manager Operations, the Associate Asset Protection Manager is responsible for managing the Asset Protection staff, monitoring shortage results, shortage control, investigations and apprehensions regarding internal and external theft, and implementation of store safety and awareness programs at an individual Saks Fifth Avenue location. Trusted for inventive and game changing ideas to even the most complex challenges, constantly seeks improvement and new ways to do things by challenging convention.
RN Case Manager (Collin County) Visiting Nurse Association of TexasRN Case Manager (Collin County)McKinney, TXOur hospice and palliative care programs are available across 16 counties in North Texas, including: Collin, Cooke, Dallas, Denton, Ellis, Fannin, Grayson, Henderson, Hunt, Johnson, Kaufman, Rockwall, Tarrant, Van Zandt, and parts of Wise and Navarro Counties. Primary functions are to administer nursing care for clients of all ages in their place of residence, coordinate care with the interdisciplinary team, patient/family and referring agency; and assume the responsibility for coordination of care.
Case Manager Encompass Health Rehabilitation Hospital of ProsperCase ManagerProsper, TXJoin Encompass Health, where being a Case Manager goes beyond just a job; it positions you as a vital link between exceptional care and the transformative impact on each patient's journey. Our achievements include being named one of the "World's Most Admired Companies" and receiving the Fortune 100 Best Companies to Work For® Award, among other accolades, which is nothing short of amazing.
Registered Nurse (RN) Case Manager VITAS Healthcare CorpRegistered Nurse (RN) Case ManagerCarrollton, TXOnce a week, you'll visit the local program office to meet with an interdisciplinary team, including social workers, physicians, chaplains, and nurses, who collaborate to provide holistic support for the patients and families we serve. Supported by industry-leading experts and a growing network of programs in 15+ states, VITAS empowers team members to grow toward their goals while transforming patients' lives.
Hospice Registered Nurse Case Manager (Dallas) Elara CaringHospice Registered Nurse Case Manager (Dallas)Dallas, TXAssesses hospice care patients and families to identify the physical, psychosocial, and environmental needs of patients as evidenced by documentation, clinical records, Interdisciplinary Team reports, after hours reports, and on-site evaluations. As a Registered Nurse Case Manager, you'll contribute to our success in the following ways: Ensures that all activities performed align with the vision of Elara Caring's board of directors, executive team, and the leadership of the Hospice team.
NewRegistered Nurse Case Manager Elara CaringRegistered Nurse Case ManagerDallas, TexasAssesses hospice care patients and families to identify the physical, psychosocial, and environmental needs of patients as evidenced by documentation, clinical records, Interdisciplinary Team reports, after hours reports, and on-site evaluations. We know there’s no place like home, and that’s why our teams continue to provide high-quality care to more than 60,000 patients each day in their preferred home setting.
Medical Field Case Manager-DFW Injury Management Organization, IncMedical Field Case Manager-DFWDallas, TX$45–$60 / hourContractorFor over three decades our goal has been to provide industry leading customer service to our industry partners and their injured employees, a goal that has allowed IMO to grow from Texas into other states including Arkansas, Illinois, and Oklahoma. Candidates should have significant case management experience and possess a strong working knowledge of evidence-based guidelines, including the ODG by MCG or Return-to-Work guidelines, which are crucial for effective case management.
Case Manager - IDD DFW Volunteers of America TexasCase Manager - IDD DFWEuless, TXBachelor's degree in social sciences or related field plus one year experience with intellectual and developmental disabilities OR a high school diploma/GED plus five years direct experience with intellectual and developmental disabilities OR the equivalent combination of education and experience. Organizing and directing services to ensure compliance with applicable federal law, state certification principles for participation in the Home and Community Based Services and Texas Home Living programs, and VOATX policies.
Case Manager Encompass Health Rehabilitation Hospital of City ViewCase ManagerFort Worth, TXJoin Encompass Health, where being a Case Manager goes beyond just a job; it positions you as a vital link between exceptional care and the transformative impact on each patient's journey. Our achievements include being named one of the "World's Most Admired Companies" and receiving the Fortune 100 Best Companies to Work For® Award, among other accolades, which is nothing short of amazing.
Case Manager Tailored ManagementCase ManagerLewisville, TXRemote$20 / hourYou will work closely with patients, healthcare providers, specialty pharmacies, and insurance companies to ensure timely access to prescribed therapies while delivering an exceptional patient experience. As a dedicated Case Manager, you will guide patients throughout their treatment journey by coordinating benefits, insurance approvals, medication access, and ongoing support.
Case Managers Disaster Recovery AECOMCase Managers Disaster RecoveryDallas, TXMinimum Requirements: High School + 4 Years of case management experience, preferably in a housing recovery program; or experience as a case manager or customer service representative with skills transferrable to a housing recovery program or relevant experience or demonstrated equivalency of experience and/or education. We invite you to bring your bold ideas and big dreams and become part of a global team of over 50,000 planners, designers, engineers, scientists, digital innovators, program and construction managers and other professionals delivering projects that create a positive and tangible impact around the world.
Case Manager Encompass Health Rehabilitation Hospital of ArlingtonCase ManagerArlington, TXPart timeJoin Encompass Health, where being a Case Manager goes beyond just a job; it positions you as a vital link between exceptional care and the transformative impact on each patient's journey. Our achievements include being named one of the "World's Most Admired Companies" and receiving the Fortune 100 Best Companies to Work For® Award, among other accolades, which is nothing short of amazing.
Medical Case Manager Amtrust Financial Services IncMedical Case ManagerDallas, TXMental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Computer keyboarding Auditory/Visual: Hearing, vision and talking. Responsible for helping to ensure injured employees receive appropriate level and intensity of care through use of medical and disability duration guidelines, directly related to the compensable injury and/or assist adjusters in managing medical treatment to drive resolution.
Nurse Case Manager 1 100% Virtual, Carebridge Elevance HealthNurse Case Manager 1 100% Virtual, CarebridgeGrand Prairie, TXThe Nurse Case Manager I 100% virtual, CareBridge is responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
Lead CDBG Case Manager AECOMLead CDBG Case ManagerDallas, TXWe invite you to bring your bold ideas and big dreams and become part of a global team of over 50,000 planners, designers, engineers, scientists, digital innovators, program and construction managers and other professionals delivering projects that create a positive and tangible impact around the world. Job Description: We are seeking an experienced and detail-oriented Lead Community Development Block Grants (CDBG) Case Manager to oversee case management operations for federally funded disaster recovery and housing assistance programs.
Case Manager DLA PiperCase ManagerDallas, TX$70.43–$112 / hourParticipates in all aspects of case management: Possesses extensive knowledge of product liability, mass torts and class actions matters; possesses extensive experience preparing for and participating in document collections, witness interviews, hearings, depositions, trials, arbitrations and/or mediations; possesses advanced understanding of Federal, State, and local rules and procedures as well as court filing procedures, both electronic and hard copy; acts as lead paralegal who manages cases/matters and guides/oversees attorneys, paralegals and case assistants; develops checklists, tracking systems, and other processes to improve efficiency for the practice group. While the specific job requirements of a DLA Piper position may vary depending upon scope of the job and area of specialty, there are certain universal requirements that are expected of all DLA Piper employees, which include but are not limited to: Effectively communicate, verbally and in writing, with clients, lawyers, business professionals, and third parties.
NewCase Administrator (Legal Services/Administrative Support) American Arbitration Association Inc.Case Administrator (Legal Services/Administrative Support)Dallas, TX$52,000–$55,000 / yearFull timeYou will handle day-to-day case administration through our proprietary case management system (PRISM), correspond with parties, attorneys, and neutrals, and ensure accurate scheduling, documentation, and billing processes. The American Arbitration Association (AAA) seeks a detail-oriented and service-driven Case Administrator to manage arbitration and mediation cases across a wide range of industries.
NewField RN Case Manager SNF Focus - Hunt County, Denton County And Grayson County, TX Area And Collin County, TX UnitedHealth Group Inc.Field RN Case Manager SNF Focus - Hunt County, Denton County And Grayson County, TX Area And Collin County, TXCollin Colonia, TX$60,200–$107,400 / yearAs a team member of our Senior Community Care (SCC) team, we work to provide care to patients at home, nursing homes and assisted living for senior housing. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere.
Inpatient Rehab Facility Case Manager PRN HCA HealthcareInpatient Rehab Facility Case Manager PRNDenton, TXHCA Healthcare Co-Founder If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Inpatient Rehab Facility Case Manager PRN opening. Collaborating closely with the Rehab Program Director, Facility Case Management Director, and interdisciplinary team to ensure seamless, patient-centered care.
Registered Nurse Case Manager - Hospice - North Dallas Kindful Health LLCRegistered Nurse Case Manager - Hospice - North DallasPlano, TXFull timeWe look for 3 key characteristics in each and every team member who joins Kindful including: 1.) Optimism - we acknowledge that hospice can be a tough business so during the inevitable challenging days we must remain optimistic about the future realizing that through our efforts tomorrow can be a brighter day for our patients, their families, ourselves, our families and Kindful. Job Summary : As RN Case Manager of Kindful Health you will work with the Clinical Director to lead a care team including LPN(s), Aides, MSW and Chaplain to provide best in class care to a reasonably sized case load.
Registered Nurse Case Manager - Hospice - Carrollton Kindful Health LLCRegistered Nurse Case Manager - Hospice - CarrolltonPlano, TXFull timeWe look for 3 key characteristics in each and every team member who joins Kindful including: 1.) Optimism - we acknowledge that hospice can be a tough business so during the inevitable challenging days we must remain optimistic about the future realizing that through our efforts tomorrow can be a brighter day for our patients, their families, ourselves, our families and Kindful. Job Summary : As RN Case Manager of Kindful Health you will work with the Clinical Director to lead a care team including LPN(s), Aides, MSW and Chaplain to provide best in class care to a reasonably sized case load.
PIPELINE - Case Manager - Pfizer Tailored ManagementPIPELINE - Case Manager - PfizerLewisville, TXRemote$20 / hourDelivering an exclusive model that fully integrates direct drug distribution to site-of-care with non-commercial pharmacy services, patient access support, and financial programs, Sonexus Health, a subsidiary of Cardinal Health, helps specialty pharmaceutical manufacturers have a greater connection to the patient experiences through maximization of efficiency, productivity, and quality. Personalized service and creative solutions executed through a flexible technology platform means providers are more confident in prescribing drugs, patients can more quickly obtain and complete therapy, and manufacturers can directly access more actionable insight than ever before.
Medical Case Manager I - Spanish Speaking CorVel Healthcare CorporationMedical Case Manager I - Spanish SpeakingDallas, TXRemote$63,739–$95,264 / yearPart timeIn addition, Medical Case Managers are eligible for bonus and will be provided state-of-the-art technological devices to ensure ready access to CorVel’s proprietary Case Management application, enabling staff to retrieve documents on the go and log activities as they occur. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.
Case Manager - PRN Select Rehabilitation Hospital of DentonCase Manager - PRNDenton, TexasResponsibilities: The Case Manager is responsible for the coordination of health care decisions by using a systematic approach to assure treatment plans that improve quality and outcomes, coordination of care across the continuum; promotion of cost-effective care within the allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and appropriate discharge plans. Our Inpatient Rehabilitation Hospital is committed to providing exceptional and compassionate care to best address the medical, physical, emotional, and vocational challenges for individuals with brain injuries, spinal cord injuries, neurological disorders, orthopedic issues, amputation, and multiple traumas.
Medical Case Manager I - Spanish Speaking Part-Time CorVel CorpMedical Case Manager I - Spanish Speaking Part-TimeDallas, TXRemote$63,739–$95,264 / yearIn addition, Medical Case Managers are eligible for bonus and will be provided state-of-the-art technological devices to ensure ready access to CorVel's proprietary Case Management application, enabling staff to retrieve documents on the go and log activities as they occur. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.
Medical Case Manager I - Spanish Speaking CorVel CorpMedical Case Manager I - Spanish SpeakingDallas, TXRemote$63,739–$95,264 / yearIn addition, Medical Case Managers are eligible for bonus and will be provided state-of-the-art technological devices to ensure ready access to CorVel's proprietary Case Management application, enabling staff to retrieve documents on the go and log activities as they occur. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.
RN Field Case Manager Duncanville Allegiance Home Health Services LLCRN Field Case Manager DuncanvilleDuncanville, TXPart timeThe DFW office is currently interviewing for a Home Health RN Case Manager PRN or Full Time to cover the South Dallas areas (Duncanville, Cedar Hills, Desoto, Lancaster, Hutchins & surrounding areas. #homehealth #RN #casemanager #infusionnurse #registerednurse #IV #woundcare #OASIS #RegisteredNurse.
Full Time RN Field Case Manager in Arlington TX Allegiance Home Health Services LLCFull Time RN Field Case Manager in Arlington TXArlington, TXFull timehomehealth #RN #casemanager #infusionnurse #registerednurse #IV #woundcare #OASIS #RegisteredNurse. Amcare Pro Home Health is a mid-size home health care company with offices in Dallas Fort Worth & East Texas.
Case Manager PRN Select Medical CorpCase Manager PRNDenton, TXThe Case Manager is responsible for the coordination of health care decisions by using a systematic approach to assure treatment plans that improve quality and outcomes, coordination of care across the continuum; promotion of cost-effective care within the allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and appropriate discharge plans. Our Inpatient Rehabilitation Hospital is committed to providing exceptional and compassionate care to best address the medical, physical, emotional, and vocational challenges for individuals with brain injuries, spinal cord injuries, neurological disorders, orthopedic issues, amputation, and multiple traumas.
Case manager for a Dallas Personal Injury Firm. FRENKEL & FRENKEL LLPCase manager for a Dallas Personal Injury Firm.Dallas, TXFull timePrepare case-specific documents, Ensure that case-related documents are well organized and available for review. We are seeking a highly motivated case manager with two to three years experience to join our team.