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
- ...Responsibilities Responsible for fraud and abuse detection activities for the... ...for day‑to‑day Provider investigation-related inquiries. Utilizes... ...agencies. Cooperates with fraud, waste and abuse efforts with... ...of experience working in a lead investigative role. Proven experience...FraudContract workLocal areaMonday to FridayNight shiftWeekend work
- ...is seeking a qualified individual for a fraud detection role based in San Diego, California. The position involves investigating fraud and abuse within the defined PBA Programs, interpreting... .... Candidates should have 4-6+ years of lead investigative experience, with...Fraud
- 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
$21.28 per hour
Job Description - ASSET PROTECTION/SAFETY INVESTIGATOR - HOME STORE - NAVAL BASE SAN DIEGO - PART-TIME (20 - 34.5 HRS) (260001A4)... ...of shoplifting. Investigates other suspected incidents of fraud waste and abuse as directed. Prepares case reports investigative notes and...FraudPart timeWork at officeWork from homeFlexible hours$19.5 - $24.38 per hour
...focused on shrink reduction and safety. You will observe activities to detect theft, conduct investigations, and document all stages. The role involves external interviews, reporting fraud, coordinating with store leadership, and attending court hearings as required. Travel...FraudHourly pay- ...JCPenney in San Diego, California, is seeking a Shrink to help prevent theft and fraud in the store. Responsibilities include monitoring activities, conducting investigations, and supporting safety measures to create a secure shopping environment. Qualified candidates...Fraud
$8.73k - $11.93k
California Department of Insurance seeks a Supervising Fraud Investigator I (Detective Sergeant) in San Diego County. The role leads a team of investigators in a fast-paced office environment, reviews cases, and coordinates with other agencies. A peace officer with POST...FraudPermanent employmentFull timeWork at officeRemote work- A federal law enforcement agency seeks a Special Agent to conduct high-stakes investigations, addressing national security threats like cyberattacks and fraud. Applicants should hold a bachelor's degree, demonstrate judgment, and be willing to travel. This full-time position...FraudFull timeWork at office
- The Federal Bureau of Investigation (FBI) is seeking candidates with a linguistics background to transition into an FBI Special Agent role... ...localization skills to tackle national security threats, cybercrime, and fraud while offering advanced training and growth opportunities....FraudWork at office
$79.06k - $90.92k
...Senior Compliance Analyst and SIU Investigator Corporate Headquarters - Chula Vista, CA 91914 Overview Salary Range $79,... ...the course of business or as may be assigned by the CO. Fraud Waste and Abuse Prevention and Detection Program ("FWA Program") Serve as...FraudFull timeContract workLocal area- Akraya Inc in San Diego, CA, is looking for a Seasonal Associate Risk Investigator to join the Security Incident Response team. You will help develop data protection and fraud prevention services, ensuring the highest data security standards. The role requires strong analytical...FraudSeasonal workWork at office
- Insight Service Group (ISG) is seeking experienced Surveillance Investigators in San Diego, California. The ideal candidates will possess strong work ethics and communication skills, and must be able to work independently as well as part of a team. This position involves...FraudFlexible hours
- ...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
- Intuit is seeking an Investigator to join their Ethics & Investigations team. This role involves investigating concerns related to ethical violations and conducting impartial investigations. Candidates should have strong critical thinking and interpersonal skills, alongside...
- UC San Diego Health is seeking an experienced Environmental Health & Safety (EH&S) professional to lead regulated waste compliance and waste stream management across all UC San Diego Health locations. The EH&S 4 will focus on reducing compliance risk through routine audits...
- UC San Diego Health is seeking an experienced Environmental Health & Safety (EH&S) professional to lead regulated waste compliance and waste stream management across all UC San Diego Health locations. The EH&S 4 role focuses on reducing compliance risk through audits,...
- We are continuing to build a world‑class, leading‑edge Ethics & Investigations team at Intuit. The team sits under our re‑imagined People Experience... ...Association of Workplace Investigators, Association of Certified Fraud Examiners, or other relevant organizations. Strong...FraudShift work
- About Us:Insight Service Group (ISG) is a national investigative services firm specializing in cost containment and anti-fraud related services. We provide comprehensive solutions that help our clients mitigate risk and enhance their operational integrity.Surveillance Investigator...FraudFor subcontractorAfternoon shiftEarly shiftWeekday work
- 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
- ...FOR YOU HERE EFI Global is a full-service engineering, fire investigation, environmental, health and safety, and specialty consulting services... ...grown from a boutique firm specializing in handling insurance fraud and arson cases and providing expert witness testimony, into a...FraudWork at officeLocal area
- Accenture is looking for a hands-on technical leader to join their Cyber Investigation and Forensic Response (CIFR) practice, located in San Diego, CA. The ideal candidate will have expertise in Digital Forensics and Incident Response, conducting investigations under pressure...
$30 - $38 per hour
...Career in Insurance Claims with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance and Investigation... ...extensive knowledge of insurance policies and the components of fraud to determine if claims warrant reporting to the appropriate state...FraudWork at officeLocal area- ...Assistant United States Trustee (AUST), attorneys, and associated investigative, audit, and administrative staff by performing legal... ...bankruptcy petitions, schedules, and statements to identify fraud or abuse. Draft pleadings in cases that follow established precedents...FraudWork at office
- The Home Depot is seeking an Asset Protection Specialist responsible for preventing financial loss due to theft and fraud, and for supporting safety and environmental program compliance in assigned store(s). You will use tools to minimize loss, identify incidents, review...Fraud
- ...monitor, and adjust an inventory control program and a store security program that focuses on reducing shrinkage/waste and the elimination of fraud, waste, and abuse. Establish, monitor, and adjust a variety of programs to include safety, customer relations, sanitation,...FraudLocal area
$161.5k - $218.5k
...Lead Diesel Engine Inspector (DEI) Make meaningful contributions that fuel critical outcomes for some of the most complex government... ...to ensure authenticity and protect against identity fraud. You are expected to be on camera during virtual interviews. We...FraudTemporary workRemote workFlexible hours$127.5k - $236.5k
...Job Title Lead, Program Management Job Code 38105 Job Location San Diego, CA Job Schedule... ...and performs pre‑employment substance abuse testing and background checks, where... ...employment may be subject to government security investigations and must meet eligibility requirements...Contract workFor subcontractorLocal areaFlexible hours- ...to CNSP Comptroller Staff. Contractor shall identify and report irregular vouchers or those that demonstrate potential for fraud, waste, and abuse. Contractor, as herein set forth, will have voucher reconciliation responsibilities and shall be responsible for additional...FraudFor contractorsWork at officeImmediate startRemote workMonday to FridayWeekend work
- ...responsible for overseeing audit, compliance, fraud detection, and investigative work related to the use and misuse of... ...systems. In this role, you will lead and oversee AI-focused audits looking... ...manipulation, data leakage, model abuse, unauthorized automation, synthetic...FraudWork at office2 days per week
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