• Senior Fraud and Waste

    Humana (Washington, DC)
    …a part of our caring community and help us put health first** The Senior Fraud and Waste Professional (Program Integrity Lead) is responsible for overseeing the ... monitoring and enforcement of the Fraud , Waste , and Abuse (FWA) program. This role aims to prevent and detect potential FWA activities in accordance with state… more
    Humana (11/01/25)
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  • Manager, Fraud & Waste Investigation…

    Humana (Washington, DC)
    …part of our caring community and help us put health first** The Manager, Fraud and Waste Investigator : Nurse Audit/Review performs clinical audit/validation ... and determines approach, resources, schedules and goals. The Manager, Fraud and Waste Investigator : Nurse Audit/Review validates and interprets medical… more
    Humana (11/04/25)
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  • Investigator

    Highmark Health (Washington, DC)
    …Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider ... for conducting investigations of organizational or functional activities related to alleged fraud , waste and abuse perpetrated by providers, members, facilities,… more
    Highmark Health (10/24/25)
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  • Healthcare Coding Subject Matter Expert

    General Dynamics Information Technology (Fairfax, VA)
    …Qualifications** + Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud Investigator (AHFI) designation strongly desired. + Experience with Tableau, ... a 50-person team supporting the TTP which was established in 2012 to reduce fraud , waste and abuse in healthcare data. We are GDIT. The people supporting and… more
    General Dynamics Information Technology (11/11/25)
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