• Stanford Health Care (Palo Alto, CA)
    …detailed review of medical records. Ensure compliance with Medicare, Medicaid , third-party guidelines, Local Coverage Determinations (LCD), National Coverage ... corporate compliance functions and audits to identify and eliminate waste, fraud and abuse, and inefficiencies in conformance with prescribed laws, regulations,… more
    DirectEmployers Association (11/14/25)
    - Save Job - Related Jobs - Block Source
  • Somatus (Mclean, VA)
    …+ **Payment Integrity Product Areas:** Clinical Claim Review, Payment Analytics, Fraud Capture, Utilization Review **Product Management** + **Build** business cases ... health regulations, bonus methodologies, and financial structures across Medicare, Medicaid , and commercial payers. + **A clear communicator and collaborative… more
    DirectEmployers Association (10/31/25)
    - Save Job - Related Jobs - Block Source
  • Forensic Auditor: Investigate Complex…

    New York State Civil Service (New York, NY)
    …Attorney General, Office of the Title Forensic Auditor: Investigate Complex Medicaid Fraud (6414) Occupational Category Financial, Accounting, Auditing Salary ... York State NY Zip Code 10005 Duties Description Criminal Justice Division Medicaid Fraud Control Unit - New York City Forensic Accountant/Auditor Reference No.… more
    New York State Civil Service (11/19/25)
    - Save Job - Related Jobs - Block Source
  • Assistant Attorney General 1 - Medicaid

    State of Georgia (Fulton County, GA)
    Assistant Attorney General 1 - Medicaid Fraud - Criminal Georgia -...Assistant Attorney General 1 - Medicaid Fraud - Criminal Georgia - Fulton - Atlanta ... of The Attorney General Department of Law Assistant Attorney General - Medicaid Fraud - Criminal Salary - Minimum $72,000/Year, Commensurate with Experience *To… more
    State of Georgia (09/24/25)
    - Save Job - Related Jobs - Block Source
  • Assistant Attorney General 1 - Medicaid

    State of Georgia (Fulton County, GA)
    Assistant Attorney General 1 - Medicaid Fraud -Civil Georgia - Fulton - Atlanta ... for Job Alerts The Office of the Attorney General Department of Law Medicaid Fraud Division - Civil Litigation Assistant Attorney General The mission of the… more
    State of Georgia (09/24/25)
    - Save Job - Related Jobs - Block Source
  • Attorney: Prosecute Medicaid Fraud

    New York State Civil Service (Hauppauge, NY)
    NY HELP No Agency Attorney General, Office of the Title Attorney: Prosecute Medicaid Fraud /Nursing Home Abuse (3836) Occupational Category Legal Salary Grade NS ... State NY Zip Code 11788 Duties Description Criminal Justice Division Medicaid Fraud Control Unit-Hauppauge (Suffolk County)Special Assistant Attorney General… more
    New York State Civil Service (11/19/25)
    - Save Job - Related Jobs - Block Source
  • Criminal Investigator - Medicaid

    State of Georgia (Fulton County, GA)
    Criminal Investigator - Medicaid Fraud Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/73115/other-jobs-matching/location-only) Hot ... through this announcement will serve in the Investigations section of our Medicaid Fraud Division. Duties & Responsibilities: Investigators conduct health care… more
    State of Georgia (10/10/25)
    - Save Job - Related Jobs - Block Source
  • Intake Coordinator- Medicaid Fraud

    State of Georgia (Fulton County, GA)
    Intake Coordinator- Medicaid Fraud Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/72587/other-jobs-matching/location-only) Hot ... this announcement will serve in the Investigations Section of our Medicaid Fraud & Patient Protection Division. Duties & Responsibilities: Receives incoming… more
    State of Georgia (09/26/25)
    - Save Job - Related Jobs - Block Source
  • Medical Analyst: Legal Nurse, Fraud

    New York State Civil Service (New York, NY)
    …York State NY Zip Code 10005 Duties Description Criminal Justice Division Medicaid Fraud Control Unit - AlbanyMedical AnalystReference No. MFCU_ALB_ ... Office of the New York State Attorney General's (OAG) Medicaid Fraud Control Unit (MFCU) is seeking an experienced Registered Nurse… more
    New York State Civil Service (11/19/25)
    - Save Job - Related Jobs - Block Source
  • Senior Fraud & Waste Investigator

    Humana (Oklahoma City, OK)
    …act as the primary point of contact for OHCA and other agencies such as the Medicaid Fraud Control Unit (MFCU) and coordinate all aspects of FWA activities in ... Fraud & Waste Investigator to join the Oklahoma Medicaid Team. This team of Investigators conducts investigations into...abuse involving providers who submit claims to Humana's Oklahoma Medicaid line of business. As the Senior Fraud more
    Humana (10/10/25)
    - Save Job - Related Jobs - Block Source
  • Law Enforcement Investigator II - 1

    MyFlorida (Miami, FL)
    …Position Summary: This position is in the Office of the Attorney General within the Medicaid Fraud Control Unit in Miami, Florida. This position is in the ... Medicaid Fraud Unit. The Attorney General's Medicaid Fraud Control Unit is a Florida-certified law enforcement agency. The duties of this position require… more
    MyFlorida (11/15/25)
    - Save Job - Related Jobs - Block Source
  • Nurse Investigator

    State of Georgia (Fulton County, GA)
    …Alerts The Office of the Attorney General Georgia Department of Law Nurse Investigator- Medicaid Fraud Division *To move forward in the recruiting process ALL ... filled through this announcement will serve within the Audits section of the Medicaid Fraud Division. Job Summary Under the direction of the Fraud Unit… more
    State of Georgia (09/18/25)
    - Save Job - Related Jobs - Block Source
  • Criminal Investigator or Investigative Auditor,…

    Idaho Division of Human Resources (Boise, ID)
    …be determined upon hire. Salary: $44.60 - $49.06 hourly Primary Duties: The Medicaid Fraud Control Unit (MFCU) is currently accepting applications for aCriminal ... This position is responsible for conducting complex criminal investigations involving Medicaid provider fraud , patient abuse, neglect and financial exploitation.… more
    Idaho Division of Human Resources (10/23/25)
    - Save Job - Related Jobs - Block Source
  • Recovery - Coordinator 2

    Louisiana Department of State Civil Service (Baton Rouge, LA)
    …recovery amounts and processes incoming payments. + Provides support to the Medicaid Fraud and Recovery Investigative Unit's ongoing, statewide operational ... escalated matters. + Maintains an advanced working knowledge of Medicaid and Eligibility policy to interpret Medicaid ...activities relative to restitution and fraud recoveries. + Pursues the recovery of funds from… more
    Louisiana Department of State Civil Service (11/05/25)
    - Save Job - Related Jobs - Block Source
  • Assistant Attorney General 1-6 (Statewide)

    Louisiana Department of State Civil Service (LA)
    …Team, and the Insurance Fraud Unit. The Criminal Division also serves: + Medicaid Fraud Control Unit: The Louisiana Medicaid Fraud Control ... Civil + Collections + Criminal + Federalism + Gaming + Litigation + Medicaid Fraud Control + Public Protection + No Preference Required Question Employer State… more
    Louisiana Department of State Civil Service (11/18/25)
    - Save Job - Related Jobs - Block Source
  • Deputy Director of EISG: Position for Expr. IT…

    New York State Civil Service (Albany, NY)
    …Albany State NY Zip Code 12224 Duties Description Criminal Justice Division Medicaid Fraud Control Unit - Albany-areaDeputy Director, Electronic Investigative ... ag.ny.gov/job-postings/otherThe Office of the New York State Attorney General's (OAG) Medicaid Fraud Control Unit (MFCU) is seeking an experienced IT manager to… more
    New York State Civil Service (10/10/25)
    - Save Job - Related Jobs - Block Source
  • Recovery - Coordinator 1

    Louisiana Department of State Civil Service (Baton Rouge, LA)
    …claims recovery amounts and processes incoming payments. *Provides support to the Medicaid Fraud and Recovery Investigative Unit's ongoing, statewide operational ... to escalated matters. *Develops an advanced working knowledge of Medicaid and Eligibility policy to interpret Medicaid ...activities relative to restitution and fraud recoveries. *Pursues the recovery of funds from third… more
    Louisiana Department of State Civil Service (10/07/25)
    - Save Job - Related Jobs - Block Source
  • Special Investigation Unit Lead Review Analyst…

    CVS Health (Tallahassee, FL)
    …Care Anti- Fraud Association (AHFI), or have a minimum of three years Medicaid Fraud , Waste and Abuse investigatory experience. * Billing and Coding ... effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to...lost funds, and to comply with state regulations mandating fraud plans and practices. What you will do -… more
    CVS Health (11/19/25)
    - Save Job - Related Jobs - Block Source
  • Investigator/Special Agent 1-4

    Louisiana Department of State Civil Service (LA)
    …and provides investigative services in cybercrimes, white collar crimes, and public corruption. Medicaid Fraud Control Unit: The Louisiana Medicaid Fraud ... is to investigate and prosecute health care providers who have defrauded the Medicaid program. The MFCU also investigates and prosecutes allegations of abuse, and… more
    Louisiana Department of State Civil Service (11/18/25)
    - Save Job - Related Jobs - Block Source
  • Assistant Attorney General- Continuous Recruiting

    State of Georgia (Fulton County, GA)
    …Justice + General Litigation + Government Services & Employment + Prosecutions + Medicaid Fraud + Consumer Protection + Solicitor General's Unit *To move ... as required; makes presentations at same + May prosecute fraud and corruption involving the State of Georgia's departments...fraud and abuse by providers in the Georgia Medicaid program; + Travel, as required by the position;… more
    State of Georgia (11/06/25)
    - Save Job - Related Jobs - Block Source