• Senior Fraud and Waste Investigator

    Humana (Tallahassee, FL)
    …of our caring community and help us put health first** The Senior Fraud and Waste Professional conducts investigations of allegations of fraudulent and abusive ... practices. The Senior Fraud and Waste Professional work assignments involve moderately complex...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
    Humana (11/13/25)
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  • Regulation Agent 9-P11 ( Fraud

    State of Michigan (Oakland, MI)
    Regulation Agent 9-P11 ( Fraud Investigator ) - MDHHS OIG (Oakland County) Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/5145616) Apply  ... Regulation Agent 9-P11 ( Fraud Investigator ) - MDHHS OIG (Oakland County) Salary $2,056.00 - $3,155.20 Biweekly Location Oakland, MI Job Type Permanent Full Time… more
    State of Michigan (11/19/25)
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  • Senior Fraud & Waste Investigator

    Humana (Oklahoma City, OK)
    …help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the Oklahoma Medicaid Team. This ... Medicaid line of business. As the Senior Fraud and Waste Investigator , you will serve...contact for OHCA and other agencies such as the Medicaid Fraud Control Unit (MFCU) and coordinate… more
    Humana (10/10/25)
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  • 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 ... Investigator / Special Agent 1-4 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/5143725) Apply  Investigator / Special Agent 1-4… more
    Louisiana Department of State Civil Service (11/18/25)
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  • Investigator , Special Investigative…

    Molina Healthcare (Louisville, KY)
    …ASSOCIATION** : + Health Care Anti- Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all ... **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is...when appropriate, recovery of money related to health care fraud , waste, and abuse. Duties include performing accurate and… more
    Molina Healthcare (10/18/25)
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  • Special Investigator

    AmeriHealth Caritas (Columbus, OH)
    …(ACFC). **Major Accountabilities:** + Ensures compliance with all requirements related to Special Investigation Units and fraud , waste and abuse investigations. ... administrative services. Discover more about us at www.amerihealthcaritas.com. The Investigator is responsible for conducting comprehensive investigations of reported,… more
    AmeriHealth Caritas (10/22/25)
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  • Law Enforcement Investigator II - 1

    MyFlorida (Miami, FL)
    LAW ENFORCEMENT INVESTIGATOR II - 41001296 1 Date: Nov 15,...in the Office of the Attorney General within the Medicaid Fraud Control Unit in Miami, Florida. ... Office of the Attorney General Working Title: LAW ENFORCEMENT INVESTIGATOR II - 41001296 1 Pay Plan: Career Service...This position is in the Medicaid Fraud Unit. The Attorney General's … more
    MyFlorida (11/15/25)
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  • Investigator , Coding Special

    Molina Healthcare (Ann Arbor, MI)
    **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... settings) or 5+ years of experience working in a FWA / SIU or Fraud investigations + Thorough knowledge of PC based software including Microsoft Word (edit/save… more
    Molina Healthcare (11/20/25)
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  • Medical Investigator I/II (RN Required)

    Excellus BlueCross BlueShield (Rochester, NY)
    …this position is responsible for the accurate and thorough clinical investigation of potential fraud , waste and abuse (FWA) for all lines of business. The scope of ... + Prepares recommendations on preventive/corrective measures for the deterrent of future fraud . + Supports other SIU investigators and analysts with their cases by… more
    Excellus BlueCross BlueShield (09/17/25)
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  • Clinical Investigator

    MVP Health Care (Rochester, NY)
    …thinking and continuous improvement. To achieve this, we're looking for a **Clinical Investigator ** to join #TeamMVP. This is the opportunity for you if you have ... investigation experience involving economic or insurance related matters. + A clinical investigator must have in addition to the above requirements: A duly licensed… more
    MVP Health Care (09/20/25)
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  • Special Investigation Unit Lead Review…

    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 ... each and every day. **Position Summary** **Position Summary** TThe SIU Investigator conducts investigations to effectively pursue the prevention, investigation and… more
    CVS Health (11/19/25)
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  • Ops Medical/Health Care Program Analyst

    MyFlorida (Tallahassee, FL)
    …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator ; Certified ... is to ensure fewer budgeted dollars are lost to fraud , abuse, and waste. The Office of Medicaid...Financial Crimes Investigator ; Certified Insurance Fraud Investigator ; Certified Compliance and Ethics Professional,… more
    MyFlorida (11/20/25)
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  • Medical Health Care Program Analyst

    MyFlorida (Tallahassee, FL)
    …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator ; Certified ... and abuse prevention efforts within the Bureau of Medicaid Program Integrity (MPI). MPI is organized by the...Financial Crimes Investigator ; Certified Insurance Fraud Investigator ; Certified Compliance and Ethics Professional,… more
    MyFlorida (11/20/25)
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