Senior Healthcare Fraud Investigator (Remote)
Centene Corporation
- Remote job
Centene Corporation is seeking a senior investigator to independently lead complex fraud, waste, and abuse investigations across providers, members, pharmacies, vendors, and other entities. You will analyze claims data, medical records, and financial information to identify issues and guide case direction. Responsibilities include preparing detailed reports for leadership and regulatory agencies, collaborating with Compliance, Legal, and government partners, and driving improvements to detection #J-18808-Ljbffr Centene Corporation
- Centene Corporation, a national leader in diversified healthcare, seeks a seasoned investigator to guide team members, investigate fraud, waste and abuse, and mentor staff. This remote role covers the continental United States and emphasizes compliance with CMS guidelines...Remote jobSenior
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- ...Highmark Inc. seeks a detail-oriented investigator to develop and maintain an anti-fraud program, conduct investigations into fraud/waste/abuse, and coordinate with law enforcement, regulators, and internal committees. The role may involve onsite or offsite interviews...Senior
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$46.99k - $122.4k
...CVS Health is looking for a skilled individual to manage healthcare fraud investigations in New Jersey. The role entails handling complex cases, facilitating legal proceedings, and working closely with law enforcement agencies. The ideal candidate will have a Bachelor'...SeniorFull time- ...humanity and inspire hope. Overview Responsible for complex fraud and abuse investigations and data analysis to identify trends, detect fraud and... ...groups or cases involving multiple perpetrators or intricate healthcare fraud schemes. Investigate fraud and abuse tips received...SeniorLocal area
- ...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...Remote work
- ...Humana Inc. is seeking a Fraud and Waste Professional 2 to conduct investigations of fraudulent and abusive practices. The role involves coordinating with compliance... ..., and preparing complex reports. The position is remote anywhere in the US with occasional travel for...Remote work
- ...Centene Corporation is seeking an investigator in Arkansas to tackle healthcare fraud and abuse activities. The role involves conducting thorough investigations, performing data analysis, and preparing reports for federal and state agencies. The ideal candidate should...Remote workFlexible hours
$65k - $88.6k
...Humana is looking for an experienced Healthcare Investigator to join its industry leading Special Investigations... ...do you have a passion for combating Fraud, Waste, and Abuse in the Health Care... ...STYLE: Work at Home. While this is a remote position, occasional travel to Humana'...Remote workFull timeTemporary workFor contractorsApprenticeshipWork experience placementWork at officeLocal areaWork from homeHome officeMonday to Friday$100k - $150k
...today and tomorrow.Ascensus is seeking a Senior Fraud Strategy Analyst to join our Fraud Risk... ...experience in fraud strategy, fraud investigations, financial crimes, or financial services... ...directly through our website.SummaryLocation: Remote, Pennsylvania; Remote, Nationwide;...Remote workSeniorFull time- ...Corporation in the United States is seeking an experienced investigator to independently lead complex fraud, waste, and abuse investigations across providers,... ...a Bachelor's degree in a related field, 4+ years in healthcare investigations, and experience coordinating with...Remote jobSenior
- Centene Corporation seeks an experienced Investigator to lead complex fraud, waste, and abuse investigations affecting providers, members, and vendors. You will analyze claims data, medical records, and interviews to identify schemes and overpayments, and guide investigations...Remote jobSenior
- Byline Bank in Chicago, IL is seeking a Fraud Analyst II to conduct complex fraud investigations, review transactions and customer accounts, and prepare SAIRs and SARs in line with regulatory requirements. This full-time role supports fraud loss recovery, collaborates...Remote jobSeniorFull timeWork at office
- Highmark Inc. is seeking a qualified investigator to develop and maintain an anti-fraud program, conduct investigations into potential fraud, and coordinate... ...should have a bachelor’s degree and 3 years of healthcare fraud experience. The position entails collaborating...Senior
- CVS Health is seeking an experienced investigator to handle complex health care fraud cases within a prepayment environment. You will research, prepare,... ...referrals, while coordinating with law enforcement and healthcare providers across Florida. The role requires 3+ years...Senior
- Medica in Minnetonka, MN is seeking an SIU Investigator III to lead complex investigations into fraud, waste, and abuse involving members, providers, and employees. You will work with legal teams and regulatory agencies, perform on-site audits, analyze evidence, and prepare...SeniorWork at office
- ...Levels (Investigator, Sr. Investigator, etc) will depend on experience and qualifications... ...detection, investigation and prevention of healthcare fraud, waste and abuse (FWA). We are growing... ...to work independently within a remote team, under minimal supervision Benefits...Remote workFull time
- Praescient Analytics is seeking a Senior Investigative Analyst to assist in federal fraud detection and program integrity initiatives. Candidates should possess strong analytical problem-solving skills and a minimum of three years of experience investigating complex fraud...Remote jobSenior
- Humana Inc. is seeking a Fraud and Waste Professional 2 to coordinate investigations of fraudulent and abusive practices across internal and external entities,... ...audit reports in support of adjudication. This is a remote opportunity in the United States with occasional...Remote job
$65k - $88.6k
Humana Inc. is seeking a Fraud and Waste Investigator to conduct investigations of fraudulent and abusive practices. The role is remote nationwide with standard 40-hour weeks and a pay... ...Bachelor's degree and at least two years in healthcare fraud investigations, with knowledge...Remote job- ...Estágios e Treinamentos seeks a Medicaid Fraud Investigator to join its Special Investigations Unit. This role focuses on identifying healthcare fraud, conducting audits, data analysis... ...skills, and MS Office proficiency. Remote work from the Chicago area is preferred...Remote job
- Humana Inc. is seeking an experienced Healthcare Investigator to join its Special Investigations Unit (SIU). You will conduct healthcare fraud investigations, collaborate with law enforcement, and prepare reports to support adjudication while ensuring compliance with Humana...Remote job
- Navanti Group, LLC is seeking a senior healthcare fraud investigator and OSINT analyst to support a sensitive federal law-enforcement customer. The role... ...of fraudulent activity. The position is fully remote, requires an active Top Secret clearance, and demands 5+...Remote job
- The Cigna Group in Miami, FL is hiring a Bilingual Junior Healthcare Fraud Investigator to join the Special Investigations Unit. You will support audits and investigations of potentially fraudulent claim activity by providers, using analytical and investigative skills to...Remote job
$65k - $88.6k
...part of our caring community The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and... ...We are fortunate to offer a remote opportunity for this job. Our Fortune... ...2 years of experience in healthcare fraud investigations Knowledge...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$50k - $70k
...Insurance Premium Audit Team, offering a competitive compensation package between $50K and $70K in total earnings. The role includes remote work options, comprehensive training, and career advancement opportunities. Benefits feature 17 days of paid vacation, 8 paid...Remote jobSenior
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