Healthcare SIU Fraud Investigator & Analytics
Mass General Brigham Health Plan Holding Company, Inc.
Mass General Brigham Health Plan Holding Company, Inc. seeks a Data Analyst focused on fraud, waste and abuse investigations. The role conducts confidential investigations, data analysis, and public records research to identify improper claim submissions. The position emphasizes documentation, interviews, and reporting within a hybrid on-site schedule in Somerville, MA. The candidate will review policies, provider manuals, and BD's to support findings and stay current with industry trends in #J-18808-Ljbffr Mass General Brigham Health Plan Holding Company, Inc.
$79.56k - $115.72k
...an exciting place to be within the healthcare industry. As a member of Mass General... ...creating, refining, and performing various analytic reporting aimed at identifying... ...for conducting confidential investigations of suspected fraud, waste & abuse (FWA) involving medical...SuggestedFull timeContract workWork at officeLocal areaRemote workMonday to FridayFlexible hoursShift work- Mass General Brigham Health Plan is seeking a Data Analyst to create, refine, and perform analytic reporting aimed at identifying potential fraudulent, wasteful, or abusive claim submissions. The role includes preliminary research of providers or members, using public...SuggestedFull time
- ...General Brigham Health Plan Holding Company, Inc. is seeking an SIU Fraud Investigator for a hybrid role in Somerville, MA. The position is full-... .... The role focuses on creating, refining, and performing analytic reporting to identify potential fraud, waste, or abuse in...SuggestedFull time
$80k - $100k
...Description The Fraud Risk Sr Analyst is accountable for monitoring and developing fraud risk strategies for Citizens Commercial... ...deliverables Required Skills/Experience ~5+ years of advanced analytics work experience preferably in Financial Services industry ~...SuggestedWork experience placementWork at officeLocal areaMonday to FridayFlexible hours- ...Employment Type: Full-Time, Mid-Level Department: Litigation Support CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project in Nashville, TN. The candidate must take the initiative to ask questions to successfully complete...SuggestedFull timeWork experience placementWork at officeLocal area
$70k - $85k
...two years of public accounting experience to work within our Investigative Accounting Group. We offer a flexible, hybrid work environment... ...outgoing, self-motivated, possess strong communication and analytical skills, and enjoy a wide variety of work experiences and challenges...Work experience placementLocal areaFlexible hoursNight shift- ...Criminal Investigator (Special Agent) OIG's Office of Investigations (OI) investigates potential... ..., education, construction, and other fraud; cybercrime and identity theft; bribery,... ...regional field offices that use data analytics, cyber-tools, covert operations, and other...For contractorsWork at officeLocal areaRemote work
$16.25 - $20.4 per hour
...any acts of dishonesty from outside sources Participates in investigations and surveillance as assigned Ensures apprehensions are... ...skills ~ Basic time management skills ~ Investigative / analytical skills ~ Ability to respond appropriately to changes in direction...Hourly payTemporary workLocal areaHome officeFlexible hours$30 - $35 per hour
...opportunities for experienced, self-determined, and highly motivated Part-Time SIU INVESTIGATORS that would like to join our team of professionals in our efforts to deter and combat insurance fraud. We have several work from home, part-time and full-time hourly positions...Bi-weekly payHourly payFull timePart timeWork at officeWork from home$58.8k - $87.5k
...Join Our SIU Team: Field Investigator Opportunity on Massachusetts' North Shore or South Shore Bring... ...local law enforcement and participate in fraud-fighting organizations to strengthen... ...$0 monthly premiums—comprehensive healthcare at no cost to you. Benefits provided...Full timeWork at officeLocal areaWorldwideFlexible hours$153k - $193.8k
...So, let’s get to it! A Little About UsZelis is modernizing the healthcare financial experience across payers, providers, and healthcare... ...generative AI adoption, intelligent automation, AIOps, delivery analytics, and AI-assisted planning and decision support. IT governance,...Full timeWork experience placementWork at officeLocal areaRemote workVisa sponsorshipFlexible hours$153k - $259k
...ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.Position Summary:We are looking for a Principal UX... ...and written communication skills, attention to detail, strong analytical thinking, ability to think through a problem from multiple perspectives...Full timeTemporary workWork at office- Announcement The Department of Veterans Affairs, Office of the Inspector General (OIG), is organized into six operational units with offices in more than 60 locations throughout the country. This is an announcement where applicants will be referred throughout the...Work at office
- ...profile below and apply today! Ensures a safe and secure environment for customers, team members, and vendors. Responsible for investigating of internal and external theft, to include ORC (Organized Retail Crime) activity. Seeks best practices and continuous...Weekly payWork experience placement
$80k - $400k
...mind-body medicine Patient-centered digital health Shared decision-making Research Section faculty: 16 M.D. and Ph.D. investigators who conduct research, pursue external funding, and mentor students and fellows, including in Harvard's general medicine and...Full timeWork experience placementWork from home$98.26k - $140.37k
...support more than 5,100 clients across the global education, healthcare, travel & B2B industries, with diverse payment methods across... .... High-Pressure Decision Making: Impeccable resilience and analytical clarity in high-pressure scenarios, with the ability to manage...Full timeLocal areaImmediate start$46.99k - $112.2k
...Providers and Practices to effectively pursue the prevention, investigation and prosecution of Fraud, Waste and Abuse. Collaboration with Dental Network,... ...company. Required Qualifications ~3-5 years of healthcare fraud investigations experience ~ Experience with...Hourly payFull timeTemporary workLocal area$184k - $227.7k
...team that’s all in? At Imprivata, we deliver unified access and security management programs that eliminate friction, empowering healthcare and mission-critical organizations to work smarter, faster, and more securely.We believe work can be more than a job or task—it’s...Work at officeLocal area$122.66k - $175.23k
...support more than 5,100 clients across the global education, healthcare, travel & B2B industries, with diverse payment methods across... ...roles and functions. ~ Ability to work independently. ~ Good analytical and problem-solving skills. ~ Excel in problem-solving...Full timeLocal areaImmediate start- ...in consulting, project management, or operations, preferably in a research, academic, or technology-oriented environment Strong analytical skills with both qualitative and quantitative data Stakeholder engagement experience, such as working with clients, partners, funders...Full timePart timeFor contractorsWork at officeWork visaAfternoon shift
- ...research teams in Cambridge. You will write and refine scripts to process large datasets, develop statistical models, and contribute to analytical tools used by scientists and clinicians. Applicants should have strong programming skills (Python or R) and at least one year of...
$79k - $127.65k
...harmonize heterogeneous modalities—reconciling differences in spatial resolution, temporal scale, and dimensionality—into unified analytical frameworks Identify where cross‑modal integration produces genuine insight versus where it introduces noise or artifact,...Temporary workFixed term contractLocal areaRemote work$112.7k - $193.2k
...opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.The Director, Corporate Security...Minimum wageFull timeWork experience placementLocal areaShift work$219.2k - $301.4k
...combat climate change, reliably connect humans and the world, and help drive advancements in automation and robotics, mobility, healthcare, energy and data centers. With revenue of more than $11 billion in FY25, ADI ensures today's innovators stay Ahead of What's Possible...Permanent employmentFull timeWork at officeImmediate startDay shift- Physician: Academic Clinical Investigator- Breast OncologyBoston University Aram V. Chobanian and Edward Avedisian School of MedicineThe... ...the underserved.Our doctors are changing the face of healthcare. At every level and on every unit, BMC doctors are advancing...Full timeFor contractorsFixed term contractLocal areaNight shift
$160.72k - $179k
Toast seeks a Principal Fraud & Risk Strategy Analyst (PF-AS) in Boston MA to design dvlp & maintain fraud monitoring & risk control systems for embedded finc & fintech prods incl. defining rules thresholds & alerting mechanisms. Var. worksites: Telecomm. prmtted from anywhere...Full time$100.28k
...to develop and implement global health and safety operational strategies.Advanced knowledge of Microsoft Office products or other analytical tools and data management.Demonstrated ability to work collaboratively with others, advise senior leadership, lead cross-...For contractorsWork at officeLocal areaRemote workWorldwideOverseas- ...using new ways to explore data Conceive, implement, and test statistical models Contribute to the development and improvement of analytical tools Interface and collaborate with scientists, clinicians, and experimental experts at the Broad and with external partners Learn...Summer workLocal areaFlexible hours
- ...recognition for exceptional strides in healthcare innovation, is supported by medical societies... .... The Clinical Trial Manager (CTM) - Investigator Initiated Studies is responsible for the... ....Heartflow has become aware of a fraud where unknown entities are posing as Heartflow...Contract workWork experience placementWork at officeLocal areaWorldwideRelocationShift work
- ...appointments and serves as a primary resource for faculty, principal investigators, departments, research centers, and researchers throughout... ...database, and document management systems. Excellent analytical and problem-solving skills with sound judgment in managing sensitive...Full timeWork at office
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