- LTCG (MN)
- …activities. * Conducts and/or assists with investigative tasks * Reviews referrals of potential fraud , waste , and abuse from both auto-detection programs and ... of its customers. With illumifin, there's a brighter future A SIU/ Fraud Investigator is responsible for working with multiple business units on coordination,… more
- State of Michigan (MI)
- …Oakland, and Wayne Counties This Regulation Agent position will conduct investigations of fraud , waste or abuse by recipients, non-Medicaid providers and ... Regulation Agent 9-P11 ( Fraud Investigator ) - OIG - Macomb,...No 13 Do you have any substantiated cases of abuse or neglect reported on the Department of Health… more
- Molina Healthcare (Albuquerque, NM)
- …investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste , and abuse . Duties include performing accurate and ... to the SIU to assess and determine whether potential fraud , waste , or abuse is...Anti- Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud… more
- CVS Health (Hartford, CT)
- …investigations to effectively pursue the prevention, detection, investigation and prosecution of healthcare fraud , waste , and abuse . Also reports suspected ... fraud , waste , and abuse to state and federal agencies as required by...in Employee Competencies - Exhibits behaviors outlined in SIU Investigator Competencies - May include travel to testify in… more
- CDPHP (Albany, NY)
- …will be responsible for investigating complex insurance cases to detect internal and external fraud and abuse . The Special Investigator will research and ... Investigator will coordinate referrals of suspicious instances of fraud and abuse to state and federal...providers, and members in the identification and remediation of fraud , waste , and abuse . QUALIFICATIONS:… more
- CVS Health (Baton Rouge, LA)
- …any situation.Education: - Bachelor's degree or an additional 5 years of working health care fraud , waste and abuse investigations. Pay Range The typical pay ... will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse . Routinely handles cases that are sensitive or high… more
- US Agency for International Development (Washington, DC)
- Summary The Office of Inspector General (OIG) is committed to detecting and preventing fraud , waste , and abuse within the U. S. Agency for International ... support programs. Direct activities designed to prevent and detect fraud , waste and abuse . Lead...appointment. Applicants that have no prior series 1811 criminal investigator experience must meet the maximum age for entry… 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 ... will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse . Routinely handles cases that are sensitive or high… more
- Commonwealth Care Alliance (Boston, MA)
- …Summary:** 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...related to review processes and results. Sr Associate, FWA Investigator Coder utilizes claim analysis, document review, coding knowledge… more
- Manulife (Boston, MA)
- …all squads to drive savings associated with fraud , waste & abuse . The Senior LTC Investigator will conduct desktop investigations of high complexity ... to field investigators + Detects, investigates and prevents allegations of fraud , waste & abuse by, agents/brokers, customers, providers, POA and… more
- Premera Blue Cross (Spokane, WA)
- …(SIU), the ** Investigator III** will be responsible for investigating allegations of external fraud , waste , and abuse (FWA). The reports prepared by this ... Coder (CPC), Certified Fraud Examiner (CFE), or Accredited Health Care Fraud Investigator (AHFI) preferred. + (2) years of active experience in auditing and… more
- CVS Health (Hartford, CT)
- …Required Qualifications - Over 3 years of investigative related experience working in fraud , waste and abuse investigations and audits. - Strong ... and/or an Associate's degree with three additional years working in health care fraud , waste , and abuse investigations and audits. Pay Range The typical pay… more
- CVS Health (Trenton, NJ)
- …be willing to work EDT schedule.- Over 3 years in healthcare field working in fraud , waste and abuse investigations and audits.- Strong analytical and ... and/or an Associate's degree with three additional years working in health care fraud , waste , and abuse investigations and audits. Pay Range The typical pay… 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 ... management reports. + Knowledge of federal and state laws and regulations pertaining to fraud , waste and abuse . + Desire to work in a collaborative and… more
- CVS Health (Tallahassee, FL)
- …Must reside in Florida - 3-5 years Investigative experience in the area of healthcare fraud , waste and abuse . - Bilingual in English/Spanish - Experience ... to effectively pursue the prevention, investigation and prosecution of health care fraud and abuse , to recover lost funds, and to comply with state regulations… more
- Commerce Bank (Kansas City, MO)
- …main purpose of this job is to prevent, detect, and investigate financial crimes, waste and abuse against the Bank and the Bank's stakeholders. Essential ... stakeholders + Answer calls and emails routed to the investigator and the Duty Line and Resource mailbox +...Suspicious Activity Reports + Identify control weaknesses + Communicate fraud issues to various lines of business impacted by… more
- US Agency for International Development (Washington, DC)
- …before you submit your application package. OIG is responsible for preventing and detecting fraud , waste , abuse , and violations of law, and for promoting ... and Millennium Challenge Corporation (MCC). Responsibilities As a GS-13 Criminal Investigator you will: Conduct complex and large-scale criminal, civil, and… more
- SGI Global, LLC (Baton Rouge, LA)
- …to 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 + ... 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
- ManTech (Springfield, VA)
- …position. **Responsibilities include but are not limited to:** + Investigate complaints of fraud , waste and abuse , data spills, and network penetrations. ... **ManTech** is seeking a motivated, career and customer-oriented **Computer and Forensics Investigator ** to join our team in **Springfield, VA** . This is an… more
- CVS Health (Hartford, CT)
- …investigations to effectively pursue the prevention, detection, investigation and prosecution of healthcare fraud , waste , and abuse . Also reports suspected ... fraud , waste , and abuse to state and federal agencies as required by...years of Investigative experience in the area of healthcare fraud , waste and abuse +… more