• Eisai, Inc (Nutley, NJ)
    …benefits healthcare provides to patients, their families, and caregivers is Eisai's human health care (hhc) mission. We're a growing pharmaceutical company that ... in good standing of a state bar. Strong knowledge of FDA regulatory and fraud and abuse laws and/or pharmaceutical government price reporting laws. Ability to learn… more
    HireLifeScience (06/20/25)
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  • Novo Nordisk Inc. (Plainsboro, NJ)
    …assist with development of policies and training as needed Advising on interactions with health care providers, patients, and payors in compliance with fraud ... and abuse laws such as the US Anti-Kickback Statute and industry codes, such as the PhRMA Code on Interactions with Healthcare Providers Participating in product lifecycle planning Drafting, reviewing, and negotiating contracts Performing other duties as… more
    HireLifeScience (06/07/25)
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  • Investigator - Medicaid Fraud

    State of Georgia (Fulton County, GA)
    …of our Medicaid Fraud Division. Duties & Responsibilities: Investigators conduct health care fraud investigations. Assists criminal justice personnel, ... not limited to, Analysts, Auditors, and Prosecutors in conducting on-site health care fraud and patient abuse investigations. Develops necessary knowledge… more
    State of Georgia (07/30/25)
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  • Senior Fraud Investigations Analyst…

    BlueCross BlueShield of North Carolina (NC)
    …The Special Investigations Unit (SIU) Investigator is responsible to conduct timely and thorough health care fraud investigations on behalf of the Company. ... to case closure + Prepares and conducts presentations and/or provides content for health care fraud and abuse education and awareness **What You'll Bring** +… more
    BlueCross BlueShield of North Carolina (07/25/25)
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  • Investigator, Special Investigations Unit (Aetna…

    CVS Health (Jefferson City, MO)
    …of fraud and abuse **Required Qualifications** + 1 year experience working on health care fraud , waste, and abuse investigatory and audits required. + ... depositions, etc. **Preferred Qualifications** + 1-3 years experience working on health care fraud , waste, and abuse investigations and audits required… more
    CVS Health (07/12/25)
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  • Analyst, Investigator (Aetna SIU)

    CVS Health (Annapolis, MD)
    …- Bachelor's degree and/or an Associate's degree with three additional years working in health care fraud , waste, and abuse investigations and audits. ... Certified Fraud Examiners (CFE) - An accreditation from the National Health Care Anti- Fraud Association (AHFI). - Billing and Coding certifications such… more
    CVS Health (07/26/25)
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  • Manager Special Investigation Unit

    Corewell Health (Grand Rapids, MI)
    …equivalent experience with a managed care payer. Preferred + Preferred + CRT-Accredited Health Care Fraud Investigator (AHFI) - NHCAA National Health ... (SIU) with a focus on identifying, investigating, and resolving health insurance fraud , waste, and abuse (FWA)....health system, we advocate for equity as we care for our patients, our communities, and each other.… more
    Corewell Health (07/19/25)
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  • Investigator, Special Investigative Unit (Remote)

    Molina Healthcare (St. Petersburg, FL)
    …prevention, detection, investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste, and abuse. Duties include ... Services, Claims) to gather documentation pertinent to investigations. + Detects potential health care fraud , waste, and abuse through the identification of… more
    Molina Healthcare (07/24/25)
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  • Senior Nurse Auditor - Payment Integrity Complex…

    Elevance Health (Mason, OH)
    …locations as necessary . BA/BS preferred . Medical claims review with prior health care fraud audit/investigation experience preferred . Certification as ... monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers through prepayment claims review, post payment… more
    Elevance Health (07/30/25)
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  • Manager, Special Investigative Unit-Kentucky

    Molina Healthcare (Owensboro, KY)
    …5-7 years + Required License, Certification, Association + Active and unrestricted Accredited Health Care Fraud Investigator (AHFI) designation or Certified ... Experience** + 7-9 years + Preferred License, Certification, Association + Health Care Anti- Fraud Associate (HCAFA) designation To all current Molina… more
    Molina Healthcare (07/18/25)
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  • Departmental Analyst 9 to P11 - MCO Oversight…

    State of Michigan (Lansing, MI)
    …possess any, write "N/A". 08 Do you have experience using data analytics to identify health care fraud , waste, and abuse and/or directing Medicaid managed ... analytics? + Yes + No 09 Describe your experience using data analytics to identify health care fraud , waste, and abuse. If you do not possess any, write… more
    State of Michigan (07/30/25)
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  • Corporate ( Health Care Regulatory)…

    Fox Rothschild LLP (Sarasota, FL)
    …Abilities:** + Experience with complex health care transactions. + Experience with health care compliance and fraud and abuse matters is preferred. + ... Corporate ( Health Care Regulatory) Associate - Sarasota **Description:** With bold growth in recent years, Fox Rothschild brings together 1,000 attorneys coast… more
    Fox Rothschild LLP (06/03/25)
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  • Criminal Assistant United States Attorney

    Executive Office for US Attorneys and the Office of the US… (Great Falls, MT)
    …pornography, human trafficking, organized crime, complex securities and fraud cases, health care fraud , and public corruption. Those matters include ... homicide, sexual and non-sexual assault, burglary, drug distribution, and fraud . The successful candidate for this position will work...the trial an appellate level, involving matters such as health care , civil rights, the environment, false… more
    Executive Office for US Attorneys and the Office of the US Attorneys (07/05/25)
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  • Business Specialist, Corporate Investigations…

    CNO Financial Group (Carmel, IN)
    …or related work designations. + Eight years of relevant work experience. + Health Care Anti- Fraud Associate (HCAFA) Designation. CNO embraces flexibility ... is hiring a **Business Analyst Corporate Investigations and Support** to work Fraud , Waste, and Abuse (FWA) referrals received from internal and external sources.… more
    CNO Financial Group (06/25/25)
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  • Legal Support Analyst I

    CACI International (Los Angeles, CA)
    …to add to your skillset. The Document Management Analyst (DMA) role works closely with the Health Care Fraud attorneys in a fast-paced setting and assist in ... entry level position supporting the Department of Justice Criminal Fraud Section on critical matters? This is an opportunity...broad range of subject matters, such as financial records, health care materials, and other litigation files;… more
    CACI International (07/04/25)
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  • Student Volunteer (Undergrad)

    Executive Office for US Attorneys and the Office of the US… (Minneapolis, MN)
    …discrimination, and prisoner lawsuits. Affirmative Civil Enforcement: Environmental protection, fair housing, health care fraud , and False Claims Act ... from federal cases. Criminal Division: Prosecutes federal crimes such as fraud , public corruption, immigration offenses, national security threats, violent crime,… more
    Executive Office for US Attorneys and the Office of the US Attorneys (07/10/25)
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  • Assistant United States Attorney

    Executive Office for US Attorneys and the Office of the US… (Detroit, MI)
    …involving guns, violence, immigration, terrorism, drug trafficking, crimes against children, government program fraud , health care fraud , other white ... includes, in part, paid vacation; sick leave; holidays; telework; life insurance; health benefits; and participation in the Federal Employees Retirement System. The… more
    Executive Office for US Attorneys and the Office of the US Attorneys (07/29/25)
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  • Assistant United States Attorney (Criminal)

    Executive Office for US Attorneys and the Office of the US… (Muskogee, OK)
    …organized crime, terrorism, international narcotics, child exploitation/child pornography, human trafficking, health care fraud , complex securities and ... includes, in part, paid vacation; sick leave; holidays; telework; life insurance; health benefits; and participation in the Federal Employees Retirement System. The… more
    Executive Office for US Attorneys and the Office of the US Attorneys (07/22/25)
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  • Associate General Counsel

    Children's Hospital Boston (Boston, MA)
    …on a broad range of health care regulatory issues, including: + Health care fraud and abuse laws + Physician recruitment, especially in connection ... Category:Legal ServicesJob Posting Description:Position Summary We are seeking a senior health care attorney with extensive experience with health care more
    Children's Hospital Boston (07/09/25)
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  • Legal Support Analyst 1 (Entry Level Legal…

    CACI International (Miami, FL)
    …The Document Management Analyst (DMA I) role works closely with the Department of Justice, Health Care Fraud Division attorneys in a fast-paced setting and ... in a broad range of subject matters, such as financial records, health care materials, and other litigation files; detailed indexing of case files; drafting… more
    CACI International (06/28/25)
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