Senior Investigator, Fraud & Abuse — Special Investigations
CVS Health
CVS Health in Madison, Wisconsin is seeking a professional with strong investigative skills to analyze Pharmacy and Prescriber behaviors to combat fraud, waste, and abuse. This full-time position requires 3-5 years of investigative experience and knowledge of pharmacy terminology. The role will involve collaboration with Pharmacy Benefit Managers and law enforcement. A Bachelor's degree in Criminal Justice or equivalent is preferred, along with strong analytical and communication skills. #J-18808-Ljbffr CVS Health
$46.99k - $112.2k
...person, one family and one community at a time. Position Summary As a Senior Investigator you will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive or high profile, those that...SeniorFraudHourly payFull timeTemporary workWork at officeLocal area$46.99k - $112.2k
...Conducts high level, complex analysis of Pharmacy and Prescriber behavior to effectively pursue the prevention, investigation and prosecution of Fraud Waste and Abuse. Collaboration with Pharmacy Benefit Manager, providing meaningful evidence of Fraud, Waste and Abuse to...SeniorFraudHourly payFull timeTemporary workWork at officeLocal area- ...ABOUT US Ethos Risk Services is a leading insurance claims investigation and medical management company, specializing in surveillance and fraud detection. At the forefront, we provide accurate data and actionable insights that translate into better decision-making...FraudLocal areaNight shiftWeekend work
$25 - $30 per hour
...determined, and highly motivated SURVEILLANCE INVESTIGATORS who would like to join our team of... ...efforts to deter and combat insurance fraud. The surveillance investigator position... ...will be followed up by on-the-job and specialized training as needed. Benefits VRC provides...FraudBi-weekly payHourly payWork at office- ...claims processes and protocols. Collects data for audits/investigations into claims, utilizing a combination of analytical skills... ...resolution and closure. Identifies opportunities to target fraud, waste, and abuse or discrepancies in claims submissions. Adheres to...FraudWork experience placement
$15.5 - $19.38 per hour
...JCPenney in Madison, Wisconsin is seeking a Shrink to enhance asset protection measures by detecting theft and fraud using surveillance and direct observation. Candidates should possess strong observation skills and reliable transportation, with a high school diploma preferred...FraudHourly pay- ...will successfully obtain ongoing extramural support to conduct investigation in the area of aging and geriatrics research with a... ...and in collaboration with other SMPH and UW faculty, within a specialized field of interest including health disparities research, health...Full timePart timeImmediate start
- ...Drug Enforcement Administration Criminal Investigator GL-1811-7/9/11 positions open to U.S.... ...For more information or questions about Special Agent positions, please visit Talk to a... ...investigative reports and deliver briefings for senior personnel and other federal, state, and...Permanent employmentLocal areaRelocationTrial periodWeekend work
- ...EmergencyMD is looking for an Experienced Field Investigator in Madison, Wisconsin. This position involves conducting covert surveillance to unearth potential fraudulent insurance claims, utilizing high-quality video equipment to document findings. The ideal candidate...FraudFlexible hours
$80k - $90k
...Employment Investigator The Employment Investigator is responsible for conducting impartial and thorough investigations of employment-based complaints involving harassment, discrimination, failure to accommodate or retaliation. The Investigator will conduct interviews...Full timeWork at officeLocal areaImmediate startRemote workNight shiftWeekend work3 days per week- ...is seeking skilled and experienced Field Investigators to join our team on an "as needed" basis... ...workers' compensation, suspected fraud, liability and aimed at mitigating expenses... ...investigations, including Surveillance and Special Investigations Unit (SIU) assignments, within...FraudFlexible hours
$67.44k
...How to Become a Medicolegal Death Investigator: A Complete Career Guide Medicolegal death investigators make around $67,440 per year based... ...workforce shortages. You’ll likely find high demand for your specialized training and skills as jurisdictions nationwide try to boost...Work experience placementWork at officeLocal area- Company Overview Advance Your Career in Insurance Claims with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we...Full timeWork at officeLocal area
- Responsibilities Conduct impartial and thorough investigations of employment-based complaints involving harassment, discrimination, failure to accommodate, or retaliation. Conduct interviews, gather records, draft reports, assist in decision making and appear in hearings...Local areaNight shiftWeekend work
$15.5 - $19.38 per hour
...Wisconsin, to detect and prevent theft while supporting a safe and secure shopping environment. You'll observe activities, conduct investigations, and interact with store leadership. Ideal candidates have retail experience and a commitment to safety practices. The position...Hourly pay$169.22k - $253k
Position Overview - Senior Medical Science Liaison Otsuka America... ...within planned timelines. Leads special projects as requested by... ...registrational, post‑marketing and Investigator‑Sponsored Trials (ISTs),... ...Statement Regarding Job Recruiting Fraud Scams At Otsuka we take...SeniorFraudTemporary workLive inWork at officeLocal areaFlexible hours- Employee Benefits Corporation is seeking a Fraud Prevention Analyst to help protect the company and its customers by identifying and... ...risks. This role involves analyzing patterns, conducting investigations, and enhancing fraud prevention strategies. The ideal candidate...FraudRemote job
- ...About the Role Employee Benefits Corporation is hiring for a Fraud Prevention Analyst. In this role, you’ll help protect EBC and... ...fraud risks across our products and operations. You’ll combine investigation, analytics, and risk management to uncover patterns, strengthen...FraudWork at officeRemote workFlexible hours
$20.72 - $25.91 per hour
...Overview Quartz is looking for an individual to investigate insurance information to coordinate benefits for claim processing. Processes claims, pends, and reports, as assigned in the claims processing system. Come find your spark at Quartz! Benefits: Flexible and supportive...Full timeWork at officeRemote workWork from homeFlexible hours- ...Job Description As the Senior Category Manager, you will lead sourcing and vendor governance... ..., including those that require specialized subject matter expertise, nonstandard risk... ...Management, Vendor Risk Management Job Alert Fraud We have become aware of scams from...SeniorFraudWork at officeLocal areaRemote workFlexible hours2 days per week
- ...results in a manner appropriate for both senior executive and management review.... ...factors including experience and training, specialized skill sets, licensure and certifications... ...performance. 81,068.00 - 129,708.00 JOB ALERT FRAUD: We have become aware of scams from...SeniorFraudWork at officeLocal areaRemote workFlexible hours2 days per week
- A federal law enforcement agency is seeking Criminal Investigators to conduct complex investigations into drug-related activities. Responsibilities include preparing reports, apprehending traffickers, and testifying in court. Applicants must be U.S. citizens, capable of...
$96.11k - $143.75k
...Engineer position typically reports to a senior leader in the Packaging and Device Technology... ...physical characteristics of item, special handling, environmental and safety requirements... .... Statement Regarding Job Recruiting Fraud Scams At Otsuka we take security and...SeniorFraudTemporary workLocal areaFlexible hours$169.22k - $253k
## Senior Medical Science Liaison, Nephrology (Northern California... ...planned timelines.• Leads special projects as requested by management... ..., post-marketing and Investigator-Sponsored Trials (ISTs), health... ...Statement Regarding Job Recruiting Fraud Scams**At Otsuka we take...SeniorFraudTemporary workLive inWork at officeLocal areaFlexible hours- ...J T Becker & Co Inc is looking for skilled Field Investigators to join their team on an as-needed basis. This role is ideal for licensed... ...of insurance claim investigations, including surveillance and special investigations. The successful candidate will need to adhere to...Flexible hours
- ...J T Becker & Co Inc is seeking skilled and experienced Field Investigators to join our team in Wisconsin on an "as needed" basis. The role is perfect for a licensed investigator looking for flexible hours while providing expert investigative services. Key responsibilities...Flexible hours
- ...responsibilities, such as carrier fees. Responsibilities: Senior level contact responsible for clients' employee benefit... ...the Acrisure California Applicant Privacy Policy. Recruitment Fraud: Please visit here to learn more about our Recruitment Fraud Notice...SeniorFraudImmediate startFlexible hours
- ...Senior Software Developer Octave is looking for a Senior Software Developer to join the team. This position will be responsible for... ...so speak up and be yourself. You're valued here. Recruitment Fraud Alert: Octave posts all official job opportunities on either or...SeniorFraud
$100k - $125k
...complex or technically difficult professional liability claims by investigating and gathering information to determine the exposure on the... ...cost for our clients. Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management...SeniorFraudWork at officeLocal areaRemote workFlexible hours- J T Becker & Co Inc is seeking skilled and experienced Field Investigators to join our team on an 'as needed' basis. This role is ideal for... ...conduct a range of investigations, including surveillance and special investigations, within an assigned geographical area. Strong...Flexible hours
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