Fraud, Waste & Abuse Investigations Lead
MedImpact Healthcare Systems, Inc.
A healthcare management company based in California is looking for a Fraud Investigation Manager who will be responsible for conducting thorough investigations of potential healthcare fraud and abuse. The ideal candidate must possess strong analytical skills, excellent communication capabilities, and a deep understanding of healthcare regulations. This role involves collaborating with law enforcement and developing comprehensive plans based on investigation findings. Candidates with a degree in healthcare or law are encouraged to apply. This position requires a detail-oriented approach to ensure compliance and effective fraud prevention. #J-18808-Ljbffr MedImpact Healthcare Systems, Inc.
- * Responsible for fraud and abuse detection activities for the TennCare... ...responsible for day-to-day Provider investigation-related inquiries.* Utilizes... ...allegations of fraud, waste and abuse involving... ...Ability to influence others, lead workgroups, and coordinate service...FraudContract workLocal area
- Epwired is seeking a Global Security Investigator to conduct investigations related to fraud and Code of Conduct violations. This role involves gathering evidence, analyzing data, and collaborating with multiple teams to ensure operational integrity. Candidates should have...FraudWork experience placement
$102k - $178.4k
...DESCRIPTION The Special Projects & Investigations team is looking for an experienced, motivated... ...specialist with background in risk, digital fraud, compliance, or cyber investigations who... ...programs focused on the detection of abuse at its earliest point and identifying...FraudLocal areaWorldwideFlexible hours$60k - $130k
...audits, disputes, claims analysis, and investigations. * Deliver high-quality, accurate... ...and reimbursement, including potential fraud, waste, and abuse. * Support the development of defensible... ...work-life balance and help employees lead fulfilling lives.Learn more about our...FraudWork at officeLocal areaFlexible hours$112.9k - $257k
...C2 Datacenter Network Architect, Lead The Opportunity: A well-designed network... ...selected will be subject to a security investigation and may need to meet eligibility requirements... ...and protect against identity fraud. You are expected to be on camera during...FraudFull timeContract workPart timeWork at officeLocal areaRemote work$120k - $189k
...FICO (NYSE: FICO) is a leading global analytics software company, helping businesses in... ...production. Assist with client meetings to investigate and resolve problems. Apply data mining... ...by 90 of the top 100 US lenders. • Fraud Detection and Security - 4 billion...FraudWorldwide$122.5k - $192.5k
...FICO (NYSE: FICO) is a leading global analytics software company, helping businesses in... ...production. Assist with client meetings to investigate and resolve problems. Apply data mining... ...by 90 of the top 100 US lenders. • Fraud Detection and Security - 4 billion...FraudWorldwide$99k - $225k
...Network Engineer, Lead The Opportunity: A well-designed network is critical to... ...selected will be subject to a security investigation and may need to meet eligibility requirements... ...and protect against identity fraud. You are expected to be on camera during...FraudFull timeContract workPart timeWork at officeLocal areaRemote workWorldwide$99k - $225k
...24153 C2 Datacenter Network Architect, Lead The Opportunity: A well-designed network... ...selected will be subject to a security investigation and may need to meet eligibility requirements... ...to verify your identity and prevent fraud. Work Model Our people-first culture prioritizes...FraudFull timeContract workPart timeLocal areaRemote work- ...objectively evaluates and recommends improvements to SANDAG operations. OIPA is also the official body of SANDAG to investigate allegations of potential fraud, waste, abuse, and gross mismanagement identified by SANDAG staff or other stakeholders. OIPA prioritizes its efforts...FraudFor contractorsWork at officeLocal area
- Global Security Investigator , Sr Associate The Global Security (GS) team conducts investigations, protects the firm’s people and assets,... ...policies and procedures, customer safety, pre-employment screening, fraud investigations and security operations on a global basis in...FraudLocal area
$45 - $52 per hour
...The Materials Management Lead is responsible for overseeing daily warehouse operations, ensuring efficient material flow from receiving... ...Diego, CA. For more information, please visit Recruitment Fraud Alert Recently, we have been made aware of unauthorized individuals...FraudHourly payFull timeAfternoon shift$139.5k - $258.1k
...Machine Learning Engineer - iCloud Anti-Abuse Posted: May 15, 2026 Role Number: 200663430 Apple's iCloud Anti-Abuse team protects... ...at scale in production ~ Experience with abuse detection, fraud prevention, content filtering, or trust and safety systems ~ Expertise...FraudRelocation$139.5k - $258.1k
...The successful candidate will play a key role in prototyping new features, designing test frameworks, and conducting rigorous investigations. This role requires a strong background in software engineering, along with experience in creating hardware test environments....$120k - $189k
**FICO (NYSE: FICO)** is a leading global analytics software company, helping businesses in 100+ countries make better decisions. Join our... ...— FICO Scores are used by 90 of the top 100 US lenders.• Fraud Detection and Security — 4 billion payment cards globally are protected...FraudWorldwide- ...Services. Prepare summaries of special investigations on the occurrence of nosocomial and community... ...Report known or suspected incidents of fraud to the Administrator. Ensure that... ...are used in an efficient manner to avoid waste. Ensure that established policies governing...FraudLocal area
$77.12k - $147.39k
...and business needs. The Opportunity We are looking for a SIU Investigator (mid-level). This is a Field position. Within defined guidelines... ..., suspect claims activity in compliance with state insurance fraud-related laws and regulations and policies and procedures. The...FraudHourly payFull timeLive inLocal areaRemote work- ...Services. Prepare summaries of special investigations on the occurrence of nosocomial and community... ...Report known or suspected incidents of fraud to the Administrator. Ensure that... ...are used in an efficient manner to avoid waste. Ensure that established policies governing...FraudLocal areaImmediate start
- Overview The Global Physical Security Division is responsible for fraud management, and the protection of all NFCU personnel,... ...installation, use, and maintenance of security equipment investigations into abusive member, robberies, financial crimes, and other safety related...FraudInternshipMonday to Friday
- Shrink Observes activities to detect theft, fraud, or suspicious activity; collects investigative evidence utilizing CCTV and observations from the sales floor. Follows AP Directives and Company policy when making apprehensions. Executes required ComFraud
- ...dedicated to serving the nation through our dual mission of criminal investigations and protection. Special Agents play a critical role in... ...investigations into financial crimes, including counterfeiting, cyber fraud, and other threats to the financial infrastructure of the...Fraud
- ...management of customer or employee accidents. Report all safety risks, or issues, and illegal activity, including robbery, theft or fraud. Ability to work cooperatively in a high‑paced and sometimes stressful environment. Ability to manage conflict in a reasonable,...FraudSeasonal workLocal area
- ...incidents. Report known or suspected incidents of fraud to the Administrator. Ensure that... ...training programs (e.g., OSHA, TB, HIPAA, Abuse Prevention, Safety, Infection Control, etc... ...are used in an efficient manner to avoid waste. Ensure that appropriate MSDSs are on file...FraudTraineeshipWork at officeShift workWeekend work
- ...membership. Moreover, the Medical Director, Utilization Management - leads or meaningfully contributes to the Blue Shield priorities and... ..., Clinical Subject Matter Expert for Litigation, SIU/Waste/Fraud/Abuse, Appeals/Grievances, Case Management/Population Health, Federal...FraudFull timeWork at office
- ...Firms, Fortune 500, or a public company. Pluses for certs: Certified Fraud Examiner or Fraud Investigation. This person will be part of a delivery team, working alongside of group of 4-5 people consisting of a manager and 2/3 Senior Auditor or Lead Auditor associates....FraudFull timeMonday to Thursday
- ...with audit team members, including managers and senior/lead auditors Communicate audit results and insights to stakeholders... ...(CPA) Certified Internal Auditor (CIA) Certified Fraud Examiner (CFE) or fraud investigation experience Please submit your resume in Word or...Fraud
$33.75 - $47.5 per hour
...• Report known or suspected incidents of fraud to the Administrator. • Ensure that departmental... ...as scheduled (e.g., OSHA, TB, HIPAA, Abuse Prevention, Safety, Infection Control, etc... ...are used in an efficient manner to avoid waste. • Ensure that appropriate MSDSs are on...FraudTraineeshipWork at officeLocal areaShift work$84.36k - $93.24k
...Lead Estimator Compensation Range (Southern California Only) Salary Range: $84... ...and Employment Eligibility Substance Abuse Screening Physical Exam (if applicable... ...complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action,...For contractorsWork at officeLocal area- ...• Report known or suspected incidents of fraud to the Administrator. • Ensure that departmental... ...as scheduled (e.g., OSHA, TB, HIPAA, Abuse Prevention, Safety, Infection Control, etc... ...are used in an efficient manner to avoid waste. • Ensure that appropriate MSDSs are on...FraudPart timeTraineeshipWork at officeLocal areaShift work
- ...incidents. Report known or suspected incidents of fraud to the Administrator. Ensure that... ...training programs (e.g., OSHA, TB, HIPAA, Abuse Prevention, Safety, Infection Control, etc... ...are used in an efficient manner to avoid waste. Ensure that appropriate MSDSs are on file...FraudFull timeTraineeshipLocal areaShift work
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