- Humana (Oklahoma City, OK)
- …on business needs. **Required Qualifications** + **Must reside in Oklahoma** + Healthcare fraud , waste , and abuse investigations experience + Knowledge of ... put health first** Humana Healthy Horizons in Oklahoma is seeking a Fraud and Waste Professional 2 who conducts investigations of allegations of fraudulent and… 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 (Omaha, NE)
- …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
- State of Massachusetts (Boston, MA)
- …public money and property. The OIG is an independent agency charged with preventing and detecting fraud , waste and abuse in the use of public funds and ... functions. Together the bureaus work to prevent and detect waste , fraud and abuse of...when no crime or civil action is involved. *Senior Investigator : Position Overview* The Senior Investigator reports… more
- Highmark Health (Harrisburg, PA)
- …for conducting investigations of organizational or functional activities related to alleged fraud , waste and abuse perpetrated by providers, members, ... to complete a review of a special project, potential fraud , waste and abuse case,...(CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have… more
- Office of Inspector General (Atlanta, GA)
- Summary This office works within DOT to detect and prevent waste , fraud and abuse in departmental programs. The OIG reports to the Secretary and Congress and ... for planning, directing and conducting complex investigations of suspected fraud , waste , and abuse , and...have in the past worked as a GS-1811 Criminal Investigator in a federal OIG office must clearly demonstrate… 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
- AmeriHealth Caritas (Washington, DC)
- …+ Ensures compliance with all requirements related to Special Investigation Units and fraud , waste and abuse investigations. + Conducts investigations of ... **Special Investigator Managed Care - DMV Counties only** Location:...potential fraud , waste and / or abuse with a... fraud , waste and / or abuse with a focus on thoroughness and attention to… 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
- 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
- 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
- Premera Blue Cross (Mountlake Terrace, 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
- Environmental Protection Agency (Denver, CO)
- …& investigations of the EPA to promote economy, efficiency, and to prevent and detect fraud , waste and abuse . We strive to provide solutions to problems ... General (OIG) Office of Investigations (OI). OI criminal investigators investigate allegations of fraud , waste , abuse and misconduct impacting EPA programs… more
- CVS Health (Richmond, VA)
- …of Medical Assistance Services (DMAS) - 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
- 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
- MyFlorida (Miami, FL)
- …the Division of Public Assistance Fraud is to aggressively identify and eliminate fraud , waste , and abuse to safeguard the integrity of taxpayer funded ... FINANCIAL CRIME INVESTIGATOR II (PENDING RECLASSIFICATION) - 43061892 Date: May 9, 2024 Location: MIAMI, FL, US, 33128 The State Personnel System is an E-Verify… more
- Environmental Protection Agency (Denver, CO)
- …& investigations of the EPA to promote economy, efficiency, and to prevent and detect fraud , waste and abuse . We strive to provide solutions to problems ... General (OIG) Office of Investigations (OI). OI criminal investigators investigate allegations of fraud , waste , abuse and misconduct impacting EPA programs… 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
- Headquarters, NASA (Kennedy Space Center, FL)
- …reviews, and investigations of NASA programs and operations to prevent and detect fraud , waste , abuse , and mismanagement. The Office of Investigations ... (OI) investigates allegations of crime, cyber-crime, fraud , waste , abuse , and misconduct...projects, operations, and resources. Responsibilities As a Supervisory Criminal Investigator at the GS-1811-14 grade level, some of your… more