- 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
- 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
- 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 Massachusetts (Boston, MA)
- …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 public property. ... functions. Together the bureaus work to prevent and detect waste , fraud and abuse of public resources...when no crime or civil action is involved. *Senior Investigator : Position Overview* The Senior Investigator reports… more
- Highmark Health (Columbus, OH)
- …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
- 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
- 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 Managed Care - DMV Counties only** Location: Washington, DC... fraud , waste and / or abuse with a focus on thoroughness and… more
- MyFlorida (Tallahassee, FL)
- …Division of Public Assistance Fraud is to aggressively identify and eliminate fraud , waste , and abuse to safeguard the integrity of taxpayer funded public ... FINANCIAL CRIME INVESTIGATOR I (PENDING RECLASSIFICATION)- 43061929 Date: Apr 15, 2024 Location: TALLAHASSEE, FL, US, 32399 The State Personnel System is an E-Verify… 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 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
- Battelle Energy Alliance dba Idaho National Laboratory (Idaho Falls, ID)
- …allegations related to environmental safety and health (ESH); quality; mismanagement; waste , fraud , and abuse (WFA); technical standards; regulatory compliance; ... Idaho National Laboratory is hiring a Workplace Concerns Investigator to work in our Workplace Concerns and Investigations department. Our team works a 9x80 schedule… more
- State of Minnesota (St. Paul, MN)
- …health, accounting, law enforcement and/or criminal justice system experience to combat waste , mismanagement, misuse, fraud , and criminal corruption in the ... **Working Title: Investigator OR Senior Investigator ** **Job Class:...take administrative or legal action in response to suspected fraud , over-utilization and/or abuse of the Minnesota Health Care… more
- 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
- MyFlorida (Tallahassee, FL)
- …(EG), R, and/or Excel. Preferred Qualifications: Industry certifications, eg, Certified Fraud Examiner; Accredited Healthcare Fraud Investigator ; Certified ... will perform data mining and investigative activities to identify fraud , waste , or abuse in claims data...Financial Crimes Investigator ; Certified Insurance Fraud Investigator , Certified Compliance and Ethics Professional.… 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 general ... reports. + Knowledge of federal and state laws and regulations pertaining to fraud , waste and abuse. + Desire to work in a collaborative and fast-paced team… more
- CVS Health (Richmond, VA)
- …Department of Medical Assistance Services- 3 years in healthcare field working in fraud , waste and abuse investigations and audits.- Strong analytical and ... an Associate's degree with three additional years working in health care fraud , waste , and abuse investigationsand audits. Pay Range The typical pay range for… more
- Office of the Director of National Intelligence (Reston, VA)
- …and conduct inquiries into possible violations of laws, rules and regulations, mismanagement, fraud , gross waste of funds, and abuse of authority within the ... are designed to prevent and detect violations of laws, rules and regulations and fraud and abuse. Manage and guide the development and presentation of briefings that… more
- CVS Health (Columbus, OH)
- …Required Qualifications + Minimum three years in healthcare field working in fraud , waste and abuse investigations and audits utilizing analytical and ... investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply with state… more
- CVS Health (Tallahassee, FL)
- …reside in Florida - 3-5 years Investigative experience in the area of healthcare fraud , waste and abuse. - Bilingual in English/Spanish - Experience with the ... pursue the prevention, investigation and prosecution of health care fraud and abuse, to recover lost funds, and to...lost funds, and to comply with state regulations mandating fraud plans. Fundamental Components: - Conducts high level, complex… more
- Federal Deposit Insurance Corporation (New York, NY)
- …or personnel irregularities with particular emphasis on white collar crime that involves fraud , abuse, and waste . Provides guidance and leadership in planning ... this announcement. Responsibilities Serves as a senior level Criminal Investigator involved in conducting investigations of complex national, international...groups, and the DOJ as a SME on financial fraud types and area to the missions of OIG… more
- ManTech (Springfield, VA)
- …computer and network security incidents. + Duties include: + Investigate complaints of fraud , waste and abuse, data spills, and network penetrations. + ... Currently, ManTech is seeking a motivated, career and customer-oriented **Forensics Investigator - Computer and Network Security** to provide unparalleled support to… more