Remote Senior Healthcare Compliance Investigator
Centene Corporation
- Remote job
Centene Corporation is seeking a clinical compliance investigations professional to lead enterprise-wide investigations for all business units and health plans. You will manage case intake, interviews, fact-finding, and reporting, ensuring adherence to policies and regulatory standards. You will collaborate with Legal, People Relations, SIU, Privacy, Finance, and Operations to drive timely remediation and maintain regulatory defensibility. Strong analytical and documentation skills are essential. #J-18808-Ljbffr Centene Corporation
- Centene Corporation seeks a seasoned Compliance Investigations leader to guide an enterprise-wide program for investigations across business units, health plans, and corporate functions. You will oversee investigations, prepare reports, and collaborate with Legal, People...Remote jobSenior
- ...Corporation, a national leader in diversified healthcare, seeks a seasoned investigator to guide team members, investigate... ...and abuse, and mentor staff. This remote role covers the continental United States and emphasizes compliance with CMS guidelines, federal and state...Remote jobSenior
- Centene Corporation in Pennsylvania is seeking a Senior Investigator to independently lead complex fraud, waste, and abuse investigations... ...patterns, and documentation to identify potential fraud and compliance concerns, develops strategies, and prepares reports for leadership...Remote jobSenior
- Centene Corporation is seeking a senior investigator to independently lead complex fraud, waste, and abuse investigations across providers... ...for leadership and regulatory agencies, collaborating with Compliance, Legal, and government partners, and driving improvements to...Remote jobSenior
$70.1k - $126.2k
...general direction of the VP of Compliance Investigations this position assists with... ...& Investigations and/or senior management regarding the status... ...in a regulated healthcare environment preferred. Experience... ...flexible approach to work with remote, hybrid, field or office...Remote workSeniorFull timePart timeWork at officeFlexible hours- We are seeking a Senior Healthcare Fraud Investigator to support our program integrity efforts through hands‑on investigation of potential fraud, waste... ...risk, analyzing claims activity, and supporting compliance with state and federal healthcare regulations—particularly...Remote workSeniorWork at office
- ...Centene Corporation seeks an experienced investigator to lead complex internal investigations. The role involves ensuring compliance with regulations and providing strategic advice to senior leadership. Applicants should have a Bachelor's Degree in a relevant field, substantial...Remote workSeniorFlexible hours
- OverviewAt Acadia Healthcare, we exist to Lead Care with Light. Every day, our teams help... ...healthcare.We are seeking a Compliance Investigator to join our Corporate Compliance team.... ...Location: Franklin, TN corporate office with remote work flexibilityTravel: Up to 25%Responsibilities...Remote workWork at office
$70k - $90k
Cotiviti is seeking a Senior Investigator to analyze suspected incidents of healthcare fraud, waste, or abuse through data analysis. The role involves evaluating instances of potential fraud and conducting interviews with patients and providers. Candidates should have...Remote jobSeniorWork from home$107.7k - $199.3k
...York seeks a highly skilled individual to lead and manage complex internal investigations. This role requires exceptional judgment and the ability to guide senior management while ensuring compliance with federal and state regulations. The ideal candidate will have 7+...Remote jobSenior- UnitedHealthcare is seeking a Sr Data Investigator to monitor patterns of potential fraud, waste... ...non-technical stakeholders and ensuring compliance within a Fortune 6 organization. You will have the flexibility to work remotely from anywhere in the U.S., with some locations...Remote jobSeniorWork at office
- Centene Corporation is seeking a seasoned Health Care Fraud Investigator to support a remote SIU team across the continental US. You will guide... ...counsel to mitigate risks. The role requires 5+ years in healthcare fraud investigations, knowledge of government programs,...Remote jobSeniorFlexible hours
- Centene Corporation is seeking a skilled Investigator to lead complex internal investigations and ensure compliance with laws and regulations. This role involves evaluating allegations, conducting interviews, and managing investigation strategies. The ideal candidate will...Remote jobSeniorFlexible hours
- Morris & Dickson Co. is seeking a Senior Compliance Specialist to strengthen the controlled substances... .... The role involves on-site visits, remote coordination with pharmacy customers,... ...Houston, TX are preferred. Strong investigative, analytic and communication skills are...Remote jobSenior
- Centene Corporation is seeking a full-time Senior Compliance Investigator to lead compliance and ethics investigations while working remotely. This role provides oversight on the development and implementation of the Compliance Investigations Program. The ideal candidate...Remote jobSeniorFull time
- The Arizona Supreme Court is seeking an Investigator - Specialist V to manage investigations into complaints against certified professionals... ...due process. After an initial in-person period, there may be remote work up to two days per week based on department needs and...Remote workSenior2 days per week
- Texas Health and Human Services Commission (HHSC) seeks an Investigator VI in Houston to conduct on-site licensure inspections and investigations... ..., including abuse, neglect, and exploitation, to assess compliance with state and federal laws. The role requires a Bachelor's...Remote workSeniorFull time
- ...in Kentucky is looking for a skilled professional to lead complex internal investigations. The ideal candidate needs 7+ years of experience in investigations, proficiency in regulatory compliance, and a bachelor’s degree in a related field. Knowledge of Federal and...Remote jobSeniorFlexible hours
- ...Palo Alto is seeking an experienced BSA/AML Investigator to detect, prevent, and report financial crimes. As part of the Legal & Compliance Team, you will support the BSA/AML... ...time with a Saturday-Wednesday schedule; remote work is allowed weekends while in-office...Remote workSeniorFull timeWork at officeWeekend work
- ...Highmark Inc. seeks a detail-oriented investigator to develop and maintain an anti-fraud program, conduct investigations into fraud/waste... ...testifying as needed, and delivering training and reports to ensure regulatory compliance and financial integrity. #J-18808-Ljbffr...Senior
£31.1k - £39.35k per year
...financial crime. More than a compliance function, we safeguard the... ...our business through robust investigations, risk management, and regulatory... ...Banking – Acquiring Senior Investigator to conduct customer... ...given Macbooks and for fully remote workers we will provide extra...Remote workSeniorFull timeLocal areaWork from homeShift work- ...Centene Corporation seeks an experienced investigator to independently lead complex fraud, waste, and abuse... ...field is required; Master's preferred. 4+ years in healthcare investigations and ability to coordinate with Compliance, Legal, and law enforcement. Certifications...Senior
- Circle is seeking a Lead KYC Utility Analyst to join the Compliance Operations team. You will oversee end-to-end KYC lifecycle processes, including onboarding, periodic reviews, event-driven reviews, and offboarding, ensuring safety and regulatory compliance across the...Remote jobSenior
$105k
...Department Overview The Electric Compliance Assurance department is part... ...incident reporting and investigations, overseeing Electric... ...is hybrid, working from your remote office and assigned office based... ...building consensus with multiple senior leaders to stay on schedule....Remote workSeniorWork experience placementWork at officeFlexible hours- ...in the United States is seeking an experienced investigator to independently lead complex fraud, waste,... ...have a Bachelor's degree in a related field, 4+ years in healthcare investigations, and experience coordinating with Compliance, #J-18808-Ljbffr Centene CorporationRemote jobSenior
- Centene Corporation seeks an experienced Investigator to lead complex fraud, waste, and abuse investigations affecting providers, members... ..., regulators, and law enforcement, while collaborating with Compliance, Legal, and external partners to support actions and program...Remote jobSenior
- ...Responsible for complex fraud and abuse investigations and data analysis to identify trends,... ...records audits, data mining, perform compliance audits of medical claims, fee screens... ...involving multiple perpetrators or intricate healthcare fraud schemes. Investigate fraud and...SeniorLocal area
- ...Chicago, IL is seeking a Fraud Analyst II to conduct complex fraud investigations, review transactions and customer accounts, and prepare SAIRs... ...role supports fraud loss recovery, collaborates with AML, Compliance, and law enforcement, and participates in improving detection...Remote jobSeniorFull timeWork at office
- ...Fraud and Waste Professional 2 to conduct investigations of fraudulent and abusive practices. The role involves coordinating with compliance, partners, and law enforcement,... ...preparing complex reports. The position is remote anywhere in the US with occasional travel...Remote work
- ...UnitedHealth Group in Omaha, Nebraska, seeks an investigator to assess fraud and misconduct allegations. You will conduct investigations, analyze data, and ensure compliance with regulations while collaborating with internal and external partners. The ideal candidate has...Remote work
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