Senior Investigator
3 weeks ago
Senior Investigator (Investigator Sr)Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate, and prevent unnecessary medical-expense spending.The Senior Investigator is responsible for the independent identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent claims.How you will make an impact:Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims.Responsible for independently identifying and developing enterprise-wide specific healthcare investigations and initiatives that may impact more than one company health plan, line of business and/or state.May interface internally with Senior level management and legal department throughout investigative process.May assist in training of internal and external entities.Assists in the development of policy and/or procedures to prevent loss of company assets.May be called upon to represent the Company in court proceedings regarding research findings.Health insurance experience required with understanding of health insurance policies, health insurance claims handling and provider network contracting.Develops and maintains a high degree of rapport and cooperation with the Federal, State and local law enforcement and regulatory agencies which can assist in investigative efforts.Minimum Requirements:Requires a BA/BS and minimum of 5 years related experience in healthcare insurance and healthcare insurance investigation, law enforcement; or any combination of education and experience, which would provide an equivalent background.Preferred Skills, Capabilities, and Experiences:Proficient in the utilization of Microsoft Excel and its functionality strongly preferred.Professional certification of CFE, AHFI, CPC, Paralegal, RN, JD or other job related designation preferred.Knowledge of Plan policies and procedures in all facets of benefit programs management with heavy emphasis in negotiation preferred.#J-18808-Ljbffr
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Embedded Hardware Security Engineer, Senior
5 days ago
Virginia, United States Booz Allen Hamilton Full timeEmbedded Hardware Security Engineer, Senior page is loaded Embedded Hardware Security Engineer, Senior Apply locations Quantico, VA time type Full time posted on Posted Yesterday job requisition id R0189459 Embedded Hardware Security Engineer, Senior The Opportunity: As an electrical engineer, you understand the workings behind complex systems. That...
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Senior Auditor
2 weeks ago
Virginia, United States Catholic Charities Community Services Full timeYou are viewing a preview of this job. Log in or register to view more details about this job. The Virginia Department of Transportation is excited to announce an opportunity to serve as a Senior Auditor in the Assurance and Compliance Office (ACO). This position is based in the VDOT Central Office located in downtown Richmond, Virginia. We are looking for...
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Virginia, United States Dexian Signature Federal Full timeCyber Security Project Engineer Location: McLean, VA Senior Cyber Operations: Required Skills • Ability to create queries and alerts that feed into a dashboard for monitoring and analysis of various logs • Experience with creating Splunk dashboards • Provide analysis and review of Splunk audit logs to include OS, database, and application logs •...
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Senior Geotechnical Engineer
5 days ago
Virginia Beach, United States Terracon Full timeJob DescriptionGeneral Responsibilities: Provide engineering and consulting services for a broad array of projects and clients. This may include performing and/or leading field investigations, engineering analysis, calculations, and recommendations, design and development of plans and specifications, observation and inspection, and the writing, preparation,...
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Senior Field Property Adjuster
2 months ago
Virginia Beach, United States Capstone ISG Inc Full timeJob DescriptionJob DescriptionDescription: Capstone ISG Inc. was founded in 2003 and is dedicated to providing accurate and high-quality claims services to insurance companies, government, and the Lloyds market. With a goal to become the nation's top adjusting company, Capstone is expanding nationwide and looking for talented Field Adjusters to join...
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Senior Fire Protection Engineer
4 days ago
Virginia Beach, United States Clark Nexsen Full timeDescription The Senior Fire Protection Engineer position is a technical role within the firm focused on project execution for a variety of multi- and single-discipline facility design projects. The Senior Fire Protection Engineer will be responsible for performing multiple aspects of fire protection engineering services on multi-discipline building design...
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FMV Analyst
5 days ago
Virginia, United States Global Dimensions Full timeGlobal Dimensions is a HUBZone, service disabled, veteran-owned small business based in Fredericksburg, VA. We are a dynamic, expanding company with exciting opportunities in language/culture, training/education/instruction, IT, cyber security, and intelligence. This position: Uses full-motion or nearly full-motion video and persistent surveillance formats...
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Senior Civil Engineering Project Manager
5 days ago
Virginia, United States Geoworld USA Full timeDescription Your Role at GEI GEI is seeking a Senior Civil Engineering Project Manager to join a talented, highly motivated geotechnical team supporting our Knoxville, TN office. The Senior Civil Engineering Project Manager will oversee site-civil and geo-environmental projects related to site development, heavy industry, and solid waste management...
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Senior Pretrial Probation Officer
3 weeks ago
Virginia Beach, United States City of Virginia Beach Full timeThe City of Virginia Beach Department of Human Services is seeking to hire a Senior Pretrial Probation Officer who has experience working with individuals with Mental Health and Substance Abuse disorders with Local Probation and Pretrial Services and experience training and coaching peers and/or co-workers for the Community Corrections and Pretrial Services...
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Software Developer
4 days ago
Virginia Beach, United States Inalab Consulting Inc Full timeJob Title: Senior Software Developer, Applications Client: FWS Environmental Conservation Online System (ECOS) Location/Remote: Falls Church, VA (2-3 days in office, 2-3 days WFH) Travel: Not required Clearance: Public Trust Citizenship: US or Green Card / Permanent Resident – must pass a Background Investigation Education (If required): BS - Computer and...
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Senior Pretrial Probation Officer
7 days ago
Virginia Beach, United States City of Virginia Beach Full timeThe City of Virginia Beach Department of Human Services is seeking to hire a Senior Pretrial Probation Officer who has experience working with individuals with Mental Health and Substance Abuse disorders with Local Probation and Pretrial Services and experience training and coaching peers and/or co-workers for the Community Corrections and Pretrial Services...
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Mechanical Engineer, Senior
5 days ago
Virginia, United States Booz Allen Hamilton Full timeApply engineering physics, engineering mathematics, and materials science principles to support the design, analysis, manufacture, or maintenance of mechanical systems. Apply leading-edge principles, theories, and concepts, and contribute to the development of new principles and concepts. Work on unusually complex problems and provide highly innovative...
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Senior Water Resilience Project Manager
4 days ago
Virginia Beach, United States Dewberry Full timeJob Description Our Virginia Beach office has an excellent opportunity for a Senior Water Resilience Project Manager with 10-20 years of experience with an emphasis on the design, and project management of large stormwater structures. Some coastal design experience is also desired. A candidate local to the Virginia Beach office is preferred, with some...
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Reimbursement and Billing Director
4 days ago
Virginia, United States Kerecis Limited Full timeAll Jobs > Reimbursement and Billing Director The Reimbursement and Billing Director oversees Benefits Investigation (BI) and Field Reimbursement and is responsible for the strategic development of building a highly functional reimbursement team that improves our value proposition for our customers. This includes collecting and implementing improvement...
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Director of Employee Relations
5 days ago
Virginia Beach, United States ECPI University Full timeOverview Director of Employee Relations This position will work at ECPI University's Virginia Beach campus located at 5555 Greenwich Road. Transform your Career at ECPI University Since 1966, the dedicated employees at ECPI University have helped students achieve their goals via practical training and career-focused education with over 50 Associates,...
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Associate Project Manager
2 months ago
Virginia Beach, United States REI Engineers Full timeJob DescriptionJob DescriptionSalary: DOEWorking under the general direction of more senior project managers and within defined guidelines, apply engineering principles and concepts learned from previous experience and and/or formal education. Plan and perform project management; assist with engineering duties for design, construction administration,...
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Senior Project Engineer
2 days ago
Virginia Beach, United States Gordie Howe Full timeRESPONSIBILITIES Lead project meetings to collect and disseminate information pertaining to the projectResponsible for technical specifications/drawings review and issue resolutionCoordinate the collection and dissemination of technical information between/within the company and the ownerResponsible to develop work plans and procedures that enables...
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Senior Technical Consulting Engineer
6 days ago
Virginia, United States Trends Group, Inc. Full timeI. PURPOSE To accomplish all assigned tasks by the management in a timely and effective manner as deemed necessary for the betterment of the organization as a whole. II. DUTIES AND RESPONSIBILITIES Assist the Technical Consulting Manager and provide mentorship and guidance to engineers. Evaluate, recommend, and implement new tools and technologies to enhance...
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Senior Cyber Security Engineer
5 days ago
Virginia Beach, United States Virpie Tech Full timeJob Responsibilities: Position Description: As part of the Cybersecurity Division, resource shall provide information systems security engineering and architecture support consisting of the following tasks: • Resource will act as Cybersecurity Engineer, assuming the responsibilities as outlined in AR 25-2. • Resource will assist in the preparation of...
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Senior Project Engineer
1 month ago
Virginia Beach, United States Gordie Howe Full timeRESPONSIBILITIESLead project meetings to collect and disseminate information pertaining to the project Responsible for technical specifications/drawings review and issue resolution Coordinate the collection and dissemination of technical information between/within the company and the owner Responsible to develop work plans and procedures that enables...