• Senior Fraud & Waste…

    Humana (Oklahoma City, OK)
    …community and help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the Oklahoma Medicaid ... to Humana's Oklahoma Medicaid line of business. As the Senior Fraud and Waste Investigator ,...**Must be an Oklahoma resident** + 2+ years of healthcare fraud investigations and auditing experience +… more
    Humana (10/10/25)
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  • Fraud Investigator

    Blue KC (Kansas City, MO)
    …AAPC, AHIMA + FWA Certification: Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI) + Medical License: Registered Nurse ... part of Blue KC's Special Investigations Unit (SIU), the Fraud Investigator conducts reviews to identify potential...clinical standards, etc. In conjunction with the Manager and/or Senior Investigator , evaluate FWA risks and prioritize… more
    Blue KC (10/16/25)
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  • Fraud Investigator

    NBT Bank (Norwich, NY)
    …Range: $24.98 - $33.31 Responsible for the entire process related to moderately complex external fraud cases in the area of check fraud , identity theft, online ... fraud , elder fraud and cyber fraud . With a solid understanding of various regulations, products...you're just starting your career or serve in a senior leadership role, your growth and development are our… more
    NBT Bank (10/21/25)
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  • Senior Investigator (Aetna SIU)

    CVS Health (Nashville, TN)
    …each and every day. **Position Summary** **WEST VIRGINIA RESIDENCY** **REQUIRED** As a Senior Investigator you will conduct high level, complex investigations of ... known or suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive or high profile, those that are national in scope, complex… more
    CVS Health (10/31/25)
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  • Senior Investigator / Human Services…

    State of Minnesota (St. Paul, MN)
    **Working Title: Senior Investigator ** **Job Class: Human Services Program Representative 2** **Agency: Human Services Dept** + **Job ID** : 89660 + **Location** ... used to fill multiple vacancies._** This position exists to utilize healthcare , accounting, law enforcement, medical coding and/or criminal justice system experience… more
    State of Minnesota (10/17/25)
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  • Senior Cyber Forensic Investigator

    Experian (Costa Mesa, CA)
    …around the world. We help to redefine lending practices, uncover and prevent fraud , simplify healthcare , create marketing solutions, and gain deeper insights ... across a range of markets, from financial services to healthcare , automotive, agribusiness, insurance, and many more industry segments....Learn more at experianplc.com. We are looking for a Senior Cyber Forensic Investigator to join our… more
    Experian (09/18/25)
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  • Investigator External Audit Special…

    Providence (Oakland, CA)
    …data mining software/tools. **Preferred Qualifications:** + Current certification as an Accredited Healthcare Fraud Investigator (AHFI) upon hire. + ... **Description** ** Investigator External Audit Special Investigations Unit \*Remote The...providing education related to coding, medical record documentation requirements, healthcare compliance and fraud , waste and abuse… more
    Providence (09/27/25)
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  • Sr. Fraud Data Analyst

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …or a related field) preferred. + Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified Professional Coder (CPC), or ... the development of investigation targets, proposes new methods of data analytics and healthcare informatics to discover Fraud , Waste and Abuse activities as well… more
    Blue Cross Blue Shield of Massachusetts (10/14/25)
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  • Director, Employee Relations

    Otsuka America Pharmaceutical Inc. (Princeton, NJ)
    **Job Summary** Otsuka Pharmaceutical Company is a global healthcare company with the corporate philosophy: "Otsuka-people creating new products for better health ... for the organization. This role will work directly with Senior members of the Otsuka Human Resources (HR) community...and values. The individual must also be a skilled investigator , both in conducting investigations and being able to… more
    Otsuka America Pharmaceutical Inc. (10/04/25)
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