- Humana (Oklahoma City, OK)
- …help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the Oklahoma Medicaid Team. This ... to Humana's Oklahoma Medicaid line of business. As the Senior Fraud and Waste Investigator , you will serve as Humana's Program Integrity Officer, and… more
- Humana (Carson City, NV)
- **Become a part of our caring community and help us put health first** The Senior Fraud and Waste Professional (Program Integrity Lead) is responsible for ... in Virgina to enhance the program's transparency and accountability. The Senior Fraud and Waste Professional also conducts investigations into allegations… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Principal Fraud Risk and Audit Analyst** **Job Class: Investigator Senior ** **Agency: Department of Employment and Economic Development** + ... and staff. The incumbent will ensure reported and actual instances of fraud , waste , and abuse are investigated, remediated, and minimized. The incumbent will… more
- Blue KC (Kansas City, MO)
- …(SIU), the Fraud Investigator conducts reviews to identify potential fraud , waste , and abuse (FWA) and claim overpayments. Assigned cases and projects ... clinical standards, etc. In conjunction with the Manager and/or Senior Investigator , evaluate FWA risks and prioritize...resources for potential FWA schemes. + Conduct investigations of fraud , waste and abuse in accordance with… more
- New York State Civil Service (Melville, NY)
- NY HELP No Agency Insurance Fund, State Title Investigator 1, Senior Investigative Officer Occupational Category Other Professional Careers Salary Grade NS ... prevention, detection, identification, elimination and exposing of criminal activity, misconduct, fraud , waste , abuse, corruption, and other improper behavior… more
- 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 ... degree or equivalent experience (3-5 years of working health care fraud , waste and abuse investigations). **Anticipated Weekly Hours** 40 **Time Type** Full… more
- 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** ... medical coding and/or criminal justice system experience to combat waste , mismanagement, misuse, and fraud in the...experience to combat waste , mismanagement, misuse, and fraud in the Minnesota Medical Assistance program. The employee… more
- Providence (Oakland, CA)
- …software/tools. **Preferred Qualifications:** + Current certification as an Accredited Healthcare Fraud Investigator (AHFI) upon hire. + Certification as an ... **Description** ** Investigator External Audit Special Investigations Unit \*Remote The...to coding, medical record documentation requirements, healthcare compliance and fraud , waste and abuse to Health Plan… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …related field) preferred. + Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified Professional Coder (CPC), or similar ... methods of data analytics and healthcare informatics to discover Fraud , Waste and Abuse activities as well...activities as well as provide program-wide trend analysis. The Senior Data Analyst will use advanced analytics, predictive modeling,… more
- City of New York (New York, NY)
- …you will lead and support investigations into complex financial matters to identify fraud , waste , and misconduct, and to prepare written work product reflecting ... that receive City funds. DOI is seeking a highly skilled and motivated Senior Investigative Auditor to join Squad 10, which oversees City agencies including the… more
- Aramco Services Company (Houston, TX)
- …Audit on special assignments beyond the normal scope of the audit function. The Senior Lead Investigator handles hotline reports or calls and manages cases of ... include assistance to external auditors or special auditors. The Senior Lead Investigator handles hotline reports or...Conducts objective, thorough, and timely investigations into allegations of fraud , waste or abuse committed by employees… more