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CONTACT GOVERNMENT SERVICES logo
CONTACT GOVERNMENT SERVICESArlington, VA

$85,000 - $105,000 / year

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 We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Posted 30+ days ago

Gresham, Smith and Partners logo
Gresham, Smith and PartnersTampa, FL
Our Healthcare team of 150+ architects, engineers, interior designers, and planners helps clients move the needle where it matters most: patient safety, operational efficiency, technology integration, adaptability/resiliency, sustainability, and the human experience. Helping create healthier communities for more than 50 years, we've designed over 8,000 projects for longstanding clients across the United States, and we invite you to join us! Gresham Smith is seeking an Architect to join our Healthcare Studio. In this role, you will collaborate with multi-disciplinary teams to deliver exceptional human experiences in healthcare settings. You should have strong technical skills, the ability to coordinate across multi-disciplines, and strong communication and organization skills. Experience directly with Healthcare projects is a plus. Responsibilities: Lead the delivery of small to medium size healthcare projects. Support project teams on large projects. Direct consultant and technical teams to ensure successful execution of project design and deliverables. Work alongside the Project Executive and Project Manager to create and oversee production timelines, clearly defining and meeting deadlines. Prepare, review, and coordinate deliverables, by managing the work of production staff and consultants, in accordance with our standards and in adherence to our QA/QC processes. Supervise code analysis and verify zoning requirements. Facilitate design discussions, internally and externally, and lead collaborative work sessions with consultants. Develop and present client presentations. Conduct product research and assist the team in selecting appropriate materials and systems. Attend site visits, field reviews, and project meetings and document relevant information. Review submittals, support, and/or lead field observations and agency reviews. Focus on the professional development of staff through mentorship. Promote a positive team atmosphere. Advocate for the firm's principles of design excellence by integrating sustainable practices. Minimum Qualifications: 5-year Bachelor's or Master's degree in Architecture from an NAAB accredited University program. Minimum of 8 years of job-related experience; Healthcare experience is preferred. Architecture License required. Demonstrated proficiency using Revit and AutoCAD is required. Proficiency in Rhino, Photoshop, SketchUp, Lumion, Enscape, and/or other 3D rendering software programs is a plus. Proficient in Microsoft Office applications, particularly in Outlook, Word, and Excel. Excellent knowledge of architectural building systems, accessibility guidelines, building codes, and Quality Control skills. Ability to interact professionally and comfortably with various personalities and communication styles and build and maintain excellent interpersonal relationships. Strong presentation, time management, and organizational skills. Please include a portfolio of work samples along with a resume/CV in your online application. Gresham Smith is an equal opportunity employer and does not discriminate. Everyone is invited to apply! Gresham Smith will not accept unsolicited resumes from recruiters, headhunters, contract recruiters, search firms, or employment agencies. An executed GRESHAM PLACEMENT SERVICES AGREEMENT (PSA) is required prior to any payment obligation for either a referral or recruiter fee. In the event a recruiter or agency submits a resume or candidate without a previously executed PSA, GRESHAM SMITH explicitly reserves the right to recruit and hire those candidate(s) at its discretion, and without any financial obligation whatsoever to the recruiter or agency. Any such unsolicited resume or candidate contact information, including those submitted directly to GRESHAM SMITH'S hiring managers or any other employee, shall become the property of GRESHAM SMITH upon receipt.

Posted 30+ days ago

Sierra Meadows Behavioral Health logo
Sierra Meadows Behavioral HealthFresno, CA
Description GENERAL DESCRIPTION OF THE POSITION: The Behavioral Healthcare Technician (BHT) I provides direct care and supportive services to patients in a behavioral health setting, ensuring a safe, clean, and therapeutic environment. Working under the supervision of clinical leadership, the BHT I assists with activities of daily living, monitors patient well-being, supports treatment planning, administers medications, and contributes to interdisciplinary care. The BHT plays a vital role in maintaining a culture of care and fostering positive behavioral and emotional outcomes for patients receiving treatment. Key Details: Work shift: NOC (10 PM - 6:30 AM) Work schedule: Work setting: residential, Detox/Substance Recovery Facility. ESSENTIAL FUNCTIONS:1. Patient Care & Support Assists patients with activities of daily living (ADLs) Provides personal care assistance to patients as needed Observes and influences patients' behavior positively. Support the clinical team through crisis intervention, case management, and coordination of patient treatment plans throughout treatment. Collaborate with and assist doctors, psychologists, and rehabilitation therapists working with patients to treat, rehabilitate, and return patients to the community. Medication Support & Health Monitoring Administer medications and treatments following the physician's prescriptions. Issue medications from the dispensary and maintain records in accordance with TPEG procedures. Reports symptoms, reactions, and progress of patients to the Nurse Practitioner and/or Facility manager, and appropriate action has been taken. Take and record measures of the patient's physical condition, using devices such as thermometers and blood pressure gauges. Monitor patients' physical and emotional well-being and report unusual behavior or physical ailments to the staff. Documents nursing observations. Nutrition & Meal Preparation Inventories food, labels and dates opened food items, labels food with expiration dates, organizes pantry and fridge, prepares grocery order, takes water and fridge/freezer temps. Ensures that patients receive appropriate nutrition, including shopping for groceries, preparing meals. Documentation & Communication Assist in maintaining patient records by reviewing case notes and documenting progress. Communicate patient progress by participating in interdisciplinary meetings and daily briefings. Professional Development & Improvement Initiates change to improve patient care; discusses changes with the doctor when appropriate. Utilizes educational opportunities within the facility and other avenues to maintain clinical expertise to promote personal growth and development. Supervision Assumes responsibility and accountability, including supervision of patients in the house. Environment & Safety Ensures the safety of patients by consistently completing safety checks. Maintains a clean and sanitized environment, cleaning up spills, setting up equipment, and reducing the spread of germs and infection in the patient's living area. ADDITIONAL FUNCTIONS: Performs other duties as may be assigned. Follows and supports TPEG policies and procedures. Works collaboratively and cooperatively with internal and external partners. Represents TPEG, Inc., by embodying the mission, vision, and values of the organization. Travels occasionally during the workday and on occasional overnight stays. (Compensation for mileage, food, and lodging provided.) Maintains regular attendance at work and company activities and demonstrates punctuality regarding deadlines. Displays creativity and vision in recommending new tactics and strategies. Expands and updates job knowledge through educational opportunities and professional learning. The description of job functions reflects general details as necessary to describe the principal duties, the level of knowledge and skill typically required, and the scope of responsibility, but should not be considered an all-inclusive listing of work requirements. Individuals may perform other duties as assigned, including work in other functional areas to cover absences or relief, to equalize peak work periods or otherwise to balance the workload. Employees who hold this position may be asked to perform other duties as assigned. Requirements MINIMUM QUALIFICATIONS: EDUCATION: High School Diploma, GED, or equivalent. SKILLS: Demonstrated ability to multi-task, manage client care, and maintain facility standards. OTHER EXPERIENCE / SKILLS REQUIRED: Strong leadership, communication, and organizational skills. Ability to work independently and as part of a team. Familiarity with equity and/or diversity initiatives within an organization. Written and oral communication skills sufficient to perform essential functions. Demonstrated ability to establish and maintain cooperative working relationships with other staff, supervisors, managed health care clinicians, and medical/mental health professionals. Demonstrated ability to make decisions independently and use initiative to accomplish complex assignments with general instruction and guidance. Demonstrated ability to exercise judgment and integrity on the job with confidentiality, tact, and diplomacy. Demonstrated ability to organize time and other resources to perform multiple tasks. Demonstrated ability to complete work accurately and in a timely manner with attention to detail. Demonstrated ability to work well with others and to provide effective team leadership. Proficiency in word processing and database and/or spreadsheet applications. Physical and mental attributes sufficient to perform essential functions. Demonstrated ability to recognize merit, excellence and intelligence in staff and potential employees. Valid Driver's License / Clean Driving Record Ability to pass Department of Justice (DOJ) Background Clearance PREFERRED QUALIFICATIONS: Medical Assisting certification, Certified Nursing Assistant certification. Two (2) years of experience in Medical Detox, Pharmacy, SUD, Behavioral/Mental Health, EMT, or health services setting preferred. Proficient in English Language Proficient communicator WORKING CONDITIONS: Work settings vary from offices, program sites, and stakeholder locations Travel modes can include the use of company or personal transportation

Posted 1 week ago

CONTACT GOVERNMENT SERVICES logo

Healthcare Fraud Investigator

CONTACT GOVERNMENT SERVICESArlington, VA

$85,000 - $105,000 / year

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Job Description

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

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Automate your job search with Sonara.

Submit 10x as many applications with less effort than one manual application.

pay-wall