- SGI Global, LLC (Raleigh, NC)
- SGI Global is seeking a Civil Investigator ( Healthcare Fraud and Opioid Matters) to support Affirmative Civil Enforcement ("ACE") Program for the ... position is contingent upon contract award** Responsibilities + The Civil Investigator will assist in conducting thorough...extensive research and analysis of data relating to suspected civil violations, such as healthcare fraud… more
- Humana (Oklahoma City, OK)
- …on business needs. **Required Qualifications** + **Must reside in Oklahoma** + Healthcare fraud , waste, and abuse investigations experience + Knowledge of ... first** Humana Healthy Horizons in Oklahoma is seeking a Fraud and Waste Professional 2 who conducts investigations of... healthcare payment methodologies + Strong organizational, interpersonal, and communication… more
- SGI Global, LLC (Baton Rouge, LA)
- SGI Global is seeking an Affirmative Civil Enforcement (ACE) Investigator to support the United States Attorney's Office, Middle District of Louisiana to assist ... necessary for successful litigation. + Provide specialized investigative analysis relevant to fraud on federal programs or federal civil rights violations +… more
- MyFlorida (Orlando, FL)
- …or education requirements of s. 943.135. Preference will be given to candidates with healthcare fraud investigative experience working in a Medicaid Fraud ... LAW ENFORCEMENT INVESTIGATOR II - 41001050 Date: May 15, 2024...experience, or five (5) years of work experience conducting healthcare fraud investigations. Note: All newly hired… 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...settlements on behalf of CDPHP or in preparation of civil suit. The Special Investigator will take… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …approach to uncover abuse and neglect of residents and complex financial fraud committed by healthcare providers, including hospitals, nursing homes, pharmacies, ... INVESTIGATOR /SPECIAL AGENT (1-3) Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4500803) Apply ...cyber crimes, white collar crimes, and public corruption. Medicaid Fraud Control Unit: The Louisiana Medicaid Fraud … more
- CVS Health (Baton Rouge, LA)
- … 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 ... involving multi-lines of business, or cases involving multiple perpetrators or intricate healthcare fraud schemes. - Investigates to prevent payment of… more
- CVS Health (Springfield, IL)
- … 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 ... cases involving multi-lines of business, or cases involving multipleperpetrators or intricate healthcare fraud schemes * Investigates to prevent payment of… more
- Veterans Affairs, Inspector General (Little Rock, AR)
- …of the position. Specialized experience is: - Conducting or leading criminal and civil investigations involving fraud or public corruption. In addition to the ... Office of the Counselor, Office of Audits and Evaluations, Office of Healthcare Inspections, Office of Investigations, Office of Management and Administration, and… more
- Veterans Affairs, Veterans Health Administration (Minneapolis, MN)
- …par with crimes such as homicide, involve an extensive supply chain fraud network, large scale drug diversion, prostitution rings requiring surveillance, and/or ... or personnel visiting or working at a VA property. The Criminal Investigator reports to the Chief of Police. Responsibilities Major duties and responsibilities… more
- CVS Health (Tallahassee, FL)
- …Components: - Conducts high level, complex investigations of known or suspected acts of healthcare fraud and abuse. - Routinely handles cases that are sensitive ... multi-disciplinary provider groups, or cases involving multiple perpetrators or intricate healthcare fraud schemes. - Investigates to prevent payment of… more
- New York State Civil Service (Albany, NY)
- …a police officer within a major metropolitan area, experience in the area of fraud and white collar crime and at least three years of demonstrated internal ... capital district.. Must possess a valid driver's license. Current Certified Fraud Examiner, Certified Fraud Specialist, Certified Public Accountant, Certified… more
- CDPHP (Albany, NY)
- …Analyst will be responsible for researching, investigating, and resolving instances of healthcare fraud and/or abusive conduct by internal employees, the medical ... agencies to support a management decision to pursue criminal, civil or other recovery action on the basis of...Coder (COC) Certification is preferred. + Accredited Health Care Fraud Investigator (AHFI(R)) accreditation to be obtained… more