- Humana (Oklahoma City, OK)
- …help us put health first** Humana Healthy Horizons in Oklahoma is seeking a Fraud and Waste Professional 2 who conducts investigations of allegations of ... fraudulent and abusive practices. The Fraud and Waste Professional 2 work assignments are varied and frequently require interpretation and independent… more
- Manulife (Boston, MA)
- …You will partner with all squads to drive savings associated with fraud , waste & abuse. The Senior LTC Investigator will conduct desktop investigations of ... recommendations to field investigators + Detects, investigates and prevents allegations of fraud , waste & abuse by, agents/brokers, customers, providers, POA and… more
- LTCG (MN)
- …and success of its customers. With illumifin, there's a brighter future A SIU/ Fraud Investigator is responsible for working with multiple business units on ... assists with investigative tasks * Reviews referrals of potential fraud , waste , and abuse from both auto-detection...investigator * Prepares responses for suspected or alleged fraud * Works closely with cross-functional leaders to ensure… more
- State of Michigan (MI)
- Regulation Agent 9-P11 ( Fraud Investigator ) - OIG - Macomb, Oakland, Wayne Co Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/3739587) Apply ... Regulation Agent 9-P11 ( Fraud Investigator ) - OIG - Macomb, Oakland,...Counties This Regulation Agent position will conduct investigations of fraud , waste or abuse by recipients, non-Medicaid… more
- Molina Healthcare (Albuquerque, NM)
- …ASSOCIATION** : + Health Care Anti- Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all ... investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste , and abuse. Duties include performing accurate and reliable… more
- Office of Inspector General (Atlanta, GA)
- Summary This office works within DOT to detect and prevent waste , fraud and abuse in departmental programs. The OIG reports to the Secretary and Congress and ... for planning, directing and conducting complex investigations of suspected fraud , waste , and abuse, and mismanagement in...have in the past worked as a GS-1811 Criminal Investigator in a federal OIG office must clearly demonstrate… more
- CDPHP (Albany, NY)
- …(4) years of equivalent experience required. + Designation as an Accredited Health Care Fraud Investigator preferred. + Incumbent must meet one of the minimum ... investigating complex insurance cases to detect internal and external fraud and abuse. The Special Investigator will...providers, and members in the identification and remediation of fraud , waste , and abuse. QUALIFICATIONS: + Degree… more
- Premera Blue Cross (Spokane, WA)
- …Professional Coder (CPC), Certified Fraud Examiner (CFE), or Accredited Health Care Fraud Investigator (AHFI) preferred. + (2) years of active experience in ... the ** Investigator III** will be responsible for investigating allegations of external fraud , waste , and abuse (FWA). The reports prepared by this position… more
- MyFlorida (Miami, FL)
- …Division of Public Assistance Fraud is to aggressively identify and eliminate fraud , waste , and abuse to safeguard the integrity of taxpayer funded public ... FINANCIAL CRIME INVESTIGATOR II (PENDING RECLASSIFICATION) - 43061892 Date: May 9, 2024 Location: MIAMI, FL, US, 33128 The State Personnel System is an E-Verify… more
- Commonwealth Care Alliance (Boston, MA)
- …The FWA Investigator Coder Sr. Associate is an integral part of the Fraud , Waste & Abuse (FWA) Special Investigation Unit (SIU). The position reports ... directly to the Sr. Director, Fraud , Waste & Abuse. This position utilizes...related to review processes and results. Sr Associate, FWA Investigator Coder utilizes claim analysis, document review, coding knowledge… more
- CVS Health (Baton Rouge, LA)
- …situation.Education: - Bachelor's degree or an additional 5 years of working health care fraud , waste and abuse investigations. Pay Range The typical pay range ... health care more personal, convenient and affordable. Position SummaryAs a Senior Investigator you will conduct high level, complex investigations of known or… more
- CVS Health (Springfield, IL)
- …information EDUCATION: *Bachelor's degree or an additional 5 years of working health care fraud , waste and abuse investigations. Pay Range The typical pay range ... care more personal, convenient and affordable. Position Summary: As a Senior Investigator you will conduct high level, complex investigations of known or suspected… more
- Commonwealth Care Alliance (Boston, MA)
- … Investigator works with a growing team conducting and managing Health Care Fraud , Waste and Abuse investigation and prevention activities under the general ... reports. + Knowledge of federal and state laws and regulations pertaining to fraud , waste and abuse. + Desire to work in a collaborative and fast-paced team… more
- CVS Health (Hartford, CT)
- …Required Qualifications - Over 3 years of investigative related experience working in fraud , waste and abuse investigations and audits. - Strong analytical and ... an Associate's degree with three additional years working in health care fraud , waste , and abuse investigations and audits. Pay Range The typical pay range… more
- CVS Health (Trenton, NJ)
- …willing to work EDT schedule.- Over 3 years in healthcare field working in fraud , waste and abuse investigations and audits.- Strong analytical and research ... an Associate's degree with three additional years working in health care fraud , waste , and abuse investigations and audits. Pay Range The typical pay range… more
- US Agency for International Development (Washington, DC)
- …you submit your application package. OIG is responsible for preventing and detecting fraud , waste , abuse, and violations of law, and for promoting economy, ... and Millennium Challenge Corporation (MCC). Responsibilities As a GS-13 Criminal Investigator you will: Conduct complex and large-scale criminal, civil, and… more
- Social Security Administration (IN)
- …of planning and conducting extremely complex and highly sensitive investigations related to fraud , waste , abuse, and mismanagement in SSA programs. The position ... complex investigations relating to the detection and prevention of fraud , waste , and abuse in SSA programs...date of appointment. Selectee newly assigned to the Criminal Investigator position MUST successfully complete the 9-week Criminal … more
- SGI Global, LLC (Baton Rouge, LA)
- …support civil actions to enforce federal laws or to recover federal funds lost to fraud , waste , or abuse. *Position is contingent upon award* Job Duties + Assist ... SGI Global is seeking an Affirmative Civil Enforcement (ACE) Investigator to support the United States Attorney's Office, Middle District of Louisiana to assist in… more
- Universal Health Services (Reno, NV)
- …analytics or related field + The following certifications are preferred: Accredited Healthcare Fraud Investigator (AHFI), Certified Fraud Examiner (CFE), and ... Investigations Unit is responsible for investigating and resolving high complexity healthcare fraud , waste and abuse (FWA) by medical professional, facilities,… more
- CVS Health (Tallahassee, FL)
- …reside in Florida - 3-5 years Investigative experience in the area of healthcare fraud , waste and abuse. - Bilingual in English/Spanish - Experience with the ... pursue the prevention, investigation and prosecution of health care fraud and abuse, to recover lost funds, and to...lost funds, and to comply with state regulations mandating fraud plans. Fundamental Components: - Conducts high level, complex… more