• Senior Fraud and Waste

    Humana (Indianapolis, IN)
    …a part of our caring community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, ... who will oversee the monitoring and enforcement of the fraud , waste , and abuse (FWA) compliance program...areas + Adequately staff and manage the program integrity investigator (s) responsible for all FWA detection programs and activities… more
    Humana (03/06/24)
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  • Senior Fraud and Waste

    Humana (Louisville, KY)
    …Compliance (CHC), Health Care Anti- Fraud Associate (HCAFA), Accredited Health Care Fraud Investigator (AHFI), Certified Fraud Examiner (CFE), or JD ... caring community and help us put health first** The Senior Fraud and Waste Professional conducts investigations of allegations of fraudulent and abusive… more
    Humana (01/11/24)
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  • Fraud and Waste Investigator

    Humana (Oklahoma City, OK)
    …help us put health first** Humana Healthy Horizons in Oklahoma is seeking a Fraud and Waste Professional 2 who conducts investigations of allegations of ... fraudulent and abusive practices. The Fraud and Waste Professional 2 work assignments are varied and frequently require interpretation and independent… more
    Humana (01/11/24)
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  • Sr Fraud Investigator , Vendor…

    Amazon (Arlington, VA)
    Description Amazon is seeking a data-driven, highly motivated and organized Investigator and Risk Manager of Corporate Fraud Prevention, to support ... such as invoices and payments as indicators of theft, fraud , waste or abuse. We are looking...visible role, and a successful candidate is a seasoned investigator , comfortable working with data to derive patterns and… more
    Amazon (03/21/24)
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  • Fraud Investigator - Special…

    Point32Health (Canton, MA)
    …Investigation Unit (SIU) responsible for leading complex provider investigations related to fraud , waste , and abuse, and developing action plans to address ... future loss, and monitor provider activity post-investigation + Identify root causes of fraud , waste and abuse and recommending internal and external corrective… more
    Point32Health (03/20/24)
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  • Regulation Agent 9-P11 ( Fraud

    State of Michigan (MI)
    Regulation Agent 9-P11 ( Fraud Investigator ) - OIG - Macomb, Oakland, Wayne Co Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/3739587) Apply ...  Regulation Agent 9-P11 ( Fraud Investigator ) - OIG - Macomb, Oakland,...Counties This Regulation Agent position will conduct investigations of fraud , waste or abuse by recipients, non-Medicaid… more
    State of Michigan (01/17/24)
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  • Associate Fraud Investigator

    City of New York (New York, NY)
    …combined law enforcement and regulatory agency with jurisdiction over the trade waste industry and the public wholesale markets. Under supervision, with some ... and document data to assess the vulnerability for potential fraud /wrongdoings; conducting surveillance; conducting interviews with witnesses, suspects, Licensees,… more
    City of New York (03/27/24)
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  • Investigator , SIU( New Mexico)

    Molina Healthcare (Albuquerque, NM)
    …ASSOCIATION** : + Health Care Anti- Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all ... investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste , and abuse. Duties include performing accurate and reliable… more
    Molina Healthcare (03/21/24)
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  • Senior 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 (03/22/24)
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  • OPS Financial Crime Investigator I

    MyFlorida (Miami, FL)
    …OPEN COMPETITIVE EMPLOYMENT OPPORTUNITY POSITION TITLE: OPS FINANCIAL CRIME INVESTIGATOR I DIVISION: PUBLIC ASSISTANCE FRAUD CITY: MIAMI ... OPS Financial Crime Investigator I Date: Mar 11, 2024 Location: MIAMI,... Fraud is to aggressively identify and eliminate fraud , waste , and abuse to safeguard the… more
    MyFlorida (03/13/24)
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  • Investigator III

    Premera Blue Cross (Mountlake Terrace, WA)
    …Professional Coder (CPC), Certified Fraud Examiner (CFE), or Accredited Health Care Fraud Investigator (AHFI) preferred. + (2) years of active experience in ... the ** Investigator III** will be responsible for investigating allegations of external fraud , waste , and abuse (FWA). The reports prepared by this position… more
    Premera Blue Cross (03/02/24)
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  • Special Investigator DMV Counties only

    AmeriHealth Caritas (Washington, DC)
    …Ensures compliance with all requirements related to Special Investigation Units and fraud , waste and abuse investigations. + Conducts investigations of potential ... **Special Investigator DMV Counties only** Location: Washington, DC Primary Job Function:... fraud , waste and / or abuse with a focus on thoroughness and… more
    AmeriHealth Caritas (02/28/24)
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  • MTA Office of the Inspector General - Construction…

    MTA (New York, NY)
    …and efficiency in MTA agencies and programs while also detecting and deterring waste , fraud , abuse, and misconduct. The OIG employs attorneys, auditors, ... and reporting to the Chief of Construction Monitoring & Fraud , the Construction Auditor/ Investigator is responsible, within...of complex and sensitive allegations or proactive reviews of fraud , waste and abuse relating to the… more
    MTA (01/25/24)
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  • Financial Crime Investigator I

    MyFlorida (Fort Lauderdale, FL)
    FINANCIAL CRIME INVESTIGATOR I - 43061905 Date: Feb 29, 2024... Fraud is to aggressively identify and eliminate fraud , waste , and abuse to safeguard the ... . Requisition No: 824219 Agency: Financial Services Working Title: FINANCIAL CRIME INVESTIGATOR I - 43061905 Pay Plan: Career Service Position Number: 43061905… more
    MyFlorida (03/01/24)
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  • Criminal Investigator

    Office of Inspector General (Woburn, MA)
    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 mismanagement in...have in the past worked as a GS-1811 Criminal Investigator in a federal OIG office must clearly demonstrate… more
    Office of Inspector General (03/27/24)
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  • Special Investigations Unit Senior…

    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 range ... care more personal, convenient and affordable. Position Summary: As a Senior Investigator you will conduct high level, complex investigations of known or suspected… more
    CVS Health (03/23/24)
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  • SIU Senior Investigator

    CVS Health (Hartford, CT)
    …Required Qualifications - 3-5 years Investigative experience in the area of healthcare fraud , waste and abuse. - Experience with Individual and Family Plans ... pursue the prevention, investigation and prosecution of health care fraud and abuse, to recover lost funds, and to...in Employee Competencies. - Exhibits behaviors outlined in SIU Investigator Competencies. - May include travel to testify in… more
    CVS Health (03/17/24)
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  • Senior Investigator

    City of New York (New York, NY)
    …and data mining to generate productive investigations. BFI is recruiting for two (2) Fraud Investigator II to function as Senior Investigators, who will: - ... Conduct complex investigations into allegations of fraud , waste , and/or abuse of social services...and one year of satisfactory, full-time experience as an investigator as described in "1" above; or 3. A… more
    City of New York (01/30/24)
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  • Construction Auditor/ Investigator

    New York State Civil Service (New York, NY)
    …General Legal, and reporting to the Chief of Construction Monitoring & Fraud , the Construction Auditor/ Investigator is responsible, within the mandate of ... reviews and analyses of complex and sensitive allegations or proactive reviews of fraud , waste and abuse relating to the MTA's maintenance and capital… more
    New York State Civil Service (01/12/24)
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  • SIU Investigator

    Point32Health (Canton, MA)
    …team member of the SIU, responsible for leading complex provider investigations related to fraud , waste and abuse, and developing action plans to address the ... investigative findings and prevent future loss. The Investigator works closely with other members of the SIU...monitor provider activity post-investigation + Identifying root causes of fraud , waste and abuse and recommending internal… more
    Point32Health (03/20/24)
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