- 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 United States ... Attorney's Office for the Eastern District of North Carolina. The investigator will be assigned cases and matters that vary in scope and complexity, but… more
- MyFlorida (Tallahassee, FL)
- …between very large data sets. + Proactively identify new and emerging medical & pharmacy fraud schemes through research and use of the various software ... (EG), R, and/or Excel. Preferred Qualifications: Industry certifications, eg, Certified Fraud Examiner; Accredited Healthcare Fraud Investigator ; Certified… more
- The Cigna Group (St. Louis, MO)
- **POSITION SUMMARY** The Fraud Investigator role is responsible for the development, investigation, and presentation of complex fraud and/or abuse cases. ... in an in-depth referral to impacted clients. **ESSENTIAL FUNCTIONS** + Perform fraud , waste, and abuse virtual investigations of members identified with potential… more
- AmeriHealth Caritas (Washington, DC)
- **Special Investigator Managed Care - DMV Counties only** Location: Washington, DC Primary Job Function: Compliance ID**: 29509 **Job Brief** This position will work ... integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.… more
- Elevance Health (Columbus, OH)
- …you a check, or ask you for payment as part of consideration for employment. ** Investigator II** + Job Family: FRD > Investigation + Type: Full time + Date ... + West Virginia, Charleston + Maine, South Portland **Description** Job Description ** Investigator II** **Schedule:** 1-2 days per week in the office (Hybrid 1)… more
- Elevance Health (Atlanta, GA)
- …you a check, or ask you for payment as part of consideration for employment. ** Investigator II** + Job Family: FRD > Investigation + Type: Full time + Date ... + VA, RICHMOND + VA, ROANOKE + IN, INDIANAPOLIS + VA, NORFOLK **Description** ** Investigator II** **Location** : This position will work a hybrid model (remote and… more
- Elevance Health (Iselin, NJ)
- …check, or ask you for payment as part of consideration for employment. **Senior Investigator ** + Job Family: FRD > Investigation + Type: Full time + Date Posted:Apr ... Hampshire, Manchester + Georgia, Atlanta + New Jersey, Morristown **Description** **Senior Investigator ( Investigator Sr)** _Location: This position will work a… more
- Elevance Health (Columbus, OH)
- …check, or ask you for payment as part of consideration for employment. **Senior Investigator ** + Job Family: FRD > Investigation + Type: Full time + Date Posted:Apr ... Maine, South Portland + New Jersey, Morristown **Description** Job Description **Senior Investigator ** **Schedule:** 1-2 days per week in the office (Hybrid 1)… more
- Elevance Health (Columbus, OH)
- …you a check, or ask you for payment as part of consideration for employment. ** Investigator Senior** + Job Family: FRD > Investigation + Type: Full time + Date ... + California, Costa Mesa + District of Columbia, Washington **Description** ** Investigator Senior** **Supports the Payment Integrity line of business** _Location:… more
- CVS Health (Phoenix, AZ)
- …experience working on fraud , waste and abuse issues for clients. EducationBS Pharmacy required Pharm D preferred Licensed Pharmacist in the State of AZ Pay Range ... The RPh Advisor supports the clinical operations of the Member Quality Assurance fraud , waste, and abuse program for the Federal Employee Program (FEP). The… more