Remote Medicaid & HCBS Healthcare Investigator
Staffing Solutions Organization LLC
- Remote job
Staffing Solutions Organization LLC is seeking a fully remote Healthcare Investigator licensed in Ohio (RN, LSW/LISW, or LPC/LPCC) to safeguard Medicaid recipients. You will review records, interview stakeholders, and prepare clear investigation summaries while collaborating with external agencies as required. The role emphasizes confidentiality, independent work, and adherence to HCBS and Medicaid regulations, with occasional training travel to Central Ohio. #J-18808-Ljbffr Staffing Solutions Organization LLC
- ...Licensed Professional Counselor to join our remote Healthcare Investigator team in Ohio. The role conducts investigations into Medicaid incidents, analyzes documentation,... ...ensures compliance with Ohio Medicaid and HCBS regulations. You will work independently...Remote workLocal areaWork from home
- ...Organization LLC is seeking a Healthcare Investigator I to conduct thorough... ...investigations into incidents involving Medicaid recipients and providers,... ...are met. This fully remote role supports collaboration... ..., with at least one year of HCBS experience, and demonstrates...Remote work
- ...Humana is seeking a Fraud and Waste Professional to conduct comprehensive investigations of reported, alleged, or suspected fraud involving the Medicaid program and related healthcare services. This remote role may require occasional travel to Humana offices for training or...Remote work
- ...Staffing Solutions Organization LLC (SSO) seeks a Registered Nurse Healthcare Investigator to join their Ohio-based remote team. The role focuses on investigating incidents involving Medicaid recipients and providers to protect health and welfare in Ohio. The successful...Remote work
- ...Organization LLC (SSO) seeks a Licensed Social Worker - Healthcare Investigator in Ohio. The role is fully remote within the state; you must be licensed as an LSW... ...LISW in Ohio. The position involves investigating Medicaid-related incidents to protect the health and...Remote job
- ...Staffing Solutions Organization LLC is seeking a Healthcare Investigator I to conduct investigations of Medicaid-related incidents while ensuring compliance with Ohio regulations. This fully remote Ohio position requires collaboration with internal and external stakeholders...Remote work
- ...Remote – Must be a licensed LSW, RN, or LPC in the State of Ohio Are you a licensed healthcare professional who’s passionate about protecting vulnerable... ...impact across Ohio’s Medicaid and HCBS programs. Position Summary: The Healthcare Investigator plays a critical role in...Remote workWork from homeFlexible hours
$53k - $55k
...serve. Licensed Social Worker - Healthcare Investigator - State of Ohio Work Location: Remote – Must be a licensed as an LSW... ...incidents involving Medicaid recipients and/or providers to... ...compliance with Ohio Medicaid and HCBS regulations. Essential Duties...Remote workH1bWork at officeWork from homeFlexible hours$65k - $88.6k
...for conducting comprehensive investigations of reported, alleged or... ...involving South Carolina's Medicaid Program. The Fraud and Waste... ...Responsibilities Analyze healthcare payment methodologies, billing... ...Waste Work Style Fully remote in the contiguous US, with...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday- ...Healthcare Fwa InvestigatorLevels (Investigator, Sr. Investigator, etc) will depend on experience and qualifications... ...resultsSupport multiple clients with Medicaid, Medicare, Federal Employee and... ...skillsAbility to work independently within a remote team, under minimal...Remote work
- ...Providing investigative support for special investigation unit activities, the full-time Healthcare Fraud Investigator will focus on the prevention... ..., and abuse, while working remotely. Key responsibilities... ...Knowledge of managed care, Medicaid, Medicare, and claim billing...Remote workFull time
- ...Conduct complex, in-depth investigations of reported fraud involving the full range of healthcare products. Develop and maintain relationships with law enforcement (... ...cases of reported fraud involving the Company’s Medicaid healthcare product. Develop leads from various...Remote workWork experience placement
- ...and Waste Professional to conduct comprehensive investigations of reported or suspected fraud related to Medicaid programs. The role requires coordinating with law... ...provider records to ensure billing integrity. Fully remote in the contiguous US with periodic travel...Remote work
$6,135 per month
.../2026 Agency: Department of Healthcare and Family Services Class Title... ...General, Bureau of Investigations is seeking to hire an energetic... ...abuse involving the Illinois Medicaid program, Child Care Assistance... ...available in many program areas. (Remote work may be an option for...Remote workFull timeContract workFor contractorsWork at officeLocal areaMonday to FridayFlexible hoursNight shift- ...Professional to conduct comprehensive investigations of reported or suspected fraud within Medicaid programs. The role coordinates... .... The position is fully remote in the contiguous US, with... ...Bachelor's degree and 2+ years in healthcare fraud investigations, plus strong...Remote work
- ...Professional to conduct comprehensive investigations of reported or suspected fraud in Medicaid programs. You will coordinate... ...complex reports while working remotely across the contigu US with... ...Bachelor's degree, 2+ years in healthcare fraud investigations, and strong...Remote work
- ...Fraud and Waste Professional to conduct comprehensive investigations of suspected fraud within the Medicaid program. You will coordinate with law enforcement... ...necessity and billing practices. The role is fully remote in the contiguous US, with potential travel for...Remote work
- ...seeking a Fraud and Waste Professional to conduct investigations within the Medicaid-related context. The role is fully remote in the contiguous US with potential travel to... ...include a Bachelor's degree, 2+ years in healthcare fraud investigations, and strong data...Remote work
- ...Senior Healthcare Fraud InvestigatorArlo Solutions is supporting the... ...personnel.Location: REMOTE - Local to Washington, DCClearance... ...status taxonomy, and standard investigation templates.Overpayment &... ...experience, such as Medicare/Medicaid and VHA healthcare fraud referrals...Remote workContract workFor contractorsWork at officeLocal area
- ...Peraton is seeking a Medicaid Auditor/Investigator to join SafeGuard Services in a remote capacity. You will conduct audits of Medicaid programs to ensure compliance with federal and state requirements and recover over-payments. Strong analytical skills and Excel proficiency...Remote work
$25k
...home visits with Medicare and Medicaid members within a 30- to 40‑... ...effectively. Addresses barriers to healthcare and advocates for optimal... ...with state Medicaid, LTSS, HCBS waiver, and regulatory requirements... .... Travel: While this is a remote position, occasional travel...Remote workFull timeTemporary workApprenticeshipWork at officeHome officeMonday to Friday- ...of Washington, Office of the Attorney General, is recruiting for an AGO Investigator/Analyst Supervisor in the MFAD, based in Spokane. This senior role leads complex civil and criminal healthcare fraud investigations and coordinates with multiple agencies to drive case...Remote workWork at officeFlexible hours
- ...SafeGuard Services (SGS), a subsidiary of Peraton, is seeking a Medicaid Fraud Auditor to join the SGS team. The role focuses on researching laws, conducting compliance audits across Medicaid cases, and identifying improper payments. Telework is available from any state...Remote work
- ...and Waste Professional who will conduct comprehensive investigations of suspected fraud in Medicaid-related processes. The role involves on-site audits, evidence... ...with law enforcement to support adjudication. Fully remote within the contiguous US with occasional travel, and a...Remote job
- Humana Inc. is seeking a Fraud and Waste Professional to conduct comprehensive investigations and coordinate with law enforcement to protect the Medicaid program. This fully remote role supports nationwide program integrity efforts and requires strong analytical and communication...Remote job
- ...seeking a Fraud and Waste Professional to conduct investigations of reported, alleged or suspected fraud involving Medicaid programs. You will coordinate with law... ...complex investigative and audit reports. This remote role uses data analysis to detect irregularities...Remote job
- ...and Waste Professional to conduct comprehensive investigations of reported or suspected fraud impacting Medicaid programs. The role involves coordinating with law... ...necessity and billing practices. The position is fully remote across the contiguous US with occasional travel...Remote job
$69.4k - $99.2k
...capabilities. Summary The Medicaid Fraud, Waste & Abuse (FWA)... ...questions, and supporting investigations through data analysis, documentation... ...(Up to 25%) Fully remote opportunity with the option... ...who care deeply about making healthcare work better for everyone. Build...Remote workFull timeWork at officeFlexible hours- ..., a Peraton subsidiary, is seeking a Medicaid Auditor/Investigator to perform audits and data analyses on various Medicaid programs from a remote location in the United States. The role... ...analytical skills, and knowledge of healthcare claims data. #J-18808-Ljbffr PeratonRemote job
- ...related field. Knowledge of internal audit/investigative policies and operating principles. Understanding of Medicare/Medicaid or healthcare auditing. Strong Research and analytical... ...to further his business acumen. This is a remote position. #J-18808-Ljbffr PeratonRemote workWork at office
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