Senior Investigator, Fraud & Abuse — Special Investigations
CVS Health
CVS Health in Charleston, WV is looking for an Investigator to analyze Pharmacy and Prescriber behavior related to Fraud, Waste, and Abuse. This full-time position requires 3-5 years of relevant investigative experience in Healthcare and the ability to collaborate with various stakeholders. Qualified candidates will have a Bachelor's degree in Criminal Justice and strong analytical skills. Benefits include medical, dental, and vision coverage, among others. #J-18808-Ljbffr CVS Health
$46.99k - $122.4k
...provider groups in a prepayment environment Investigates to prevent payment of fraudulent claims... ...recovery of company lost as a result of fraud matters. Assists team in identifying... ...and prosecution of healthcare fraud and abuse matters. Demonstrates high level of knowledge...SeniorFraudHourly payFull timeTemporary workLocal 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$46.99k - $122.4k
...provider groups in a prepayment environment Investigates to prevent payment of fraudulent claims... ...recovery of company lost as a result of fraud matters. Assists team in identifying... ...and prosecution of healthcare fraud and abuse matters. Demonstrates high level of...SeniorFraudHourly payFull timeTemporary workLocal area$46.99k - $122.4k
Join CVS Health in West Virginia as a key investigator in health care fraud. This role requires 3+ years in fraud investigations with knowledge of clinical issues and coding systems. You will work collaboratively on complex cases while adhering to legal standards and documentation...SeniorFraud$61.04k
...level work obtaining evidence of reported fraud or violations of rules and regulations... ...regulations. Conduct and/or assist with investigations to ensure the integrity of the WV Lottery... ...in casino or gaming operations. Special Requirements Possession of a valid driver...FraudFull timePart timeNight shift- ...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
- ...A leading investigative firm based in the United States is seeking an Experienced Field Investigator to conduct surveillance and investigative activities. The ideal candidate should demonstrate proficiency in covert surveillance techniques and possess a valid driver's...SeniorFraudWeekend work
- ...Overview The Criminal Investigation Division of the West Virginia Department of Revenue seeks an Investigator to conduct investigations of tax violations and fraud under general supervision. The role involves field-based investigative work across multiple counties, including...FraudPermanent employmentFull timePart timeHome officeFlexible hours
$46.7k - $60.7k
...Industry Operations Investigator This position is an entry-level Industry Operations Investigator responsible for conducting investigations... ..., importers, and providing support to Criminal Investigators (Special Agent) on criminal investigations. If selected for this...Permanent employmentFull timeTemporary workWork at officeRemote workRelocationTrial period- ...Forensics, Component Testing Laboratories, The Robison Group, VRC Investigations, TechLoss, Mecanica Scientific Services, and HMI we are... ...for our scale and our track record of conducting expert, specialized, and accurate investigations. Headquartered in Charlotte, North...Hourly payDaily paidPart timeRemote work
$23 - $30 per hour
...Description Command Investigations LLC is seeking an Insurance Claims Investigator with a minimum of one year of experience to become part... ...case into a story built on truth and evidence. Requirements Special Note: This role requires you to supply your own equipment, including...Hourly payPart timeSecond jobWork at officeRemote workFlexible hoursNight shift- ...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
$23 - $30 per hour
...Command Investigations LLC is seeking an Insurance Claims Investigator with a minimum of one year of experience to join a dynamic team. This role offers an hourly pay rate of $23-$30, with schedule typically Mon-Fri and location within a 2-hour radius of the posted location...Hourly pay- ...Virginia involves detecting theft, gathering evidence, and reporting incidents per policy. Responsibilities include interviews, investigations, and coordination with leadership and law enforcement. Some travel to designated stores is required. Candidate should have 1+...
$103.24k - $133.2k
JOB DESCRIPTION As an FBI special agent, you will directly impact national security by harnessing your... ...nation, protect against cyberattacks, terrorism, fraud, and evolving threats, and conduct high‑stakes investigations. Your expertise in cybersecurity will uncover crucial...FraudWork at officeLocal area- ...A federal law enforcement agency is seeking Criminal Investigators to engage in complex investigations into narcotics and drug-related activities. Responsibilities include preparing reports, apprehending drug traffickers, and conducting evidence analysis. Candidates must...Relocation package
$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$70k - $77k
...Science & Technology (GST) is seeking a Senior IT Specialist to join our team supporting... ...be subject to a government background investigation and may need to meet eligibility requirements... ...to verify your identity and prevent fraud. Work Definitions If this position is listed...SeniorFraudFull timeContract workRemote work$150.03k - $224.25k
...Associate Director of Clinical Management, the Senior Clinical Study Manager is responsible... ...labs, central IRB, IVRS, etc.), and investigative sites. • Provide leadership and guidance... .... Statement Regarding Job Recruiting Fraud Scams At Otsuka we take security and...SeniorFraudContract workTemporary workLocal areaFlexible hours$145k - $165k
...Overview: The Senior Construction Scheduler is responsible for developing, maintaining... ..., and municipal utilities. Specializing in projects using natural gas, oil, biomass... ...local law enforcement agency and report fraud at . MasTec Clean Energy & Infrastructure...SeniorFraudDaily paidFull timeContract workTemporary workWork experience placementFor subcontractorWork at officeLocal areaFlexible hoursShift work- ...Senior Marketing Manager Anywhere Type: Contract Category: Marketing Industry: Financial Services Workplace Type: Remote... ...have any indication of fraudulent activity, please contact fraud@eliassen.com . About Eliassen Group: Eliassen Group is...SeniorFraudHourly payContract workFor contractorsLocal areaRemote work
$46.99k - $122.4k
...claims, and referral to state regulators for any suspected fraud, waste, or abuse (FWA). The Auditor must also ensure that state and federal... ...reporting this to internal staff. Assisting with further investigation and/or reports to state regulators through the utilization...FraudHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hours- ...projects and create value across the life of their assets. We specialize in consulting, engineering, procurement and construction across... ...sustainable solutions. Role Worley is seeking a Senior Principal Mechanical Engineer (Lead) based in Charleston, WV. This...Senior
$10k
...grade level if you possess one (1) year of specialized experience, equivalent to at least the... ...in the use of firearms, preparing investigative reports, serving court orders (e.g., warrants... .... Leading investigations of fraud, contraband, criminal activity, threats...FraudFull timeLocal areaImmediate startRelocationNight shift$23.16 per hour
...utilizing the appropriate application and/or template. Identifies potential discrepancies in claim submissions and involves the Special Investigation Unit as necessary. Identifies issues which can be used to educate/train internal staff, streamline, and improve processes...SeniorFor contractorsWork at officeLocal area$78.45k - $117.67k
...inappropriate use of controlled substances. Interaction with Medicaid fraud, surveillance and utilization review units, and Medicaid... ...Information PG: 81 $78,448 - $117,665 Market Rate: $98,050 Special hiring rates: ~ Hiring rate at any rate in the range for...FraudPermanent employmentFull timePart timeWork at office- ...preparation produce platters/trays Inform customers of produce specials Recommend items to customers to ensure they get the products... ...or issues, and illegal activity, including: robbery, theft or fraud to store management Ability to work cooperatively in high...FraudSeasonal workRemote work
- ...regulations; report all illegal activity, including robbery, theft or fraud Comply with and reinforce all food safety, sanitation and... ...through direct interaction with minors, individuals with special needs, and/or older adults Must be able to perform the essential...FraudLocal area
- ...Permanent Discipline: Sales & Business Development About The Role Our client, who specializes in the design, development, and deployment of microgrid solutions for end users, is on the hunt for a Senior Business Development Manager to join their team. They offer cutting‑edge...SeniorPermanent employment
- ...FULLY REMOTE! Position Objective: As a Senior Human Resource Specialist, apply a broad... ...accurate conversion of general pay and special pay schedules to the law enforcement pay... ...including Electronic Questionnaires for Investigations Processing (e-QIP) initiations and...SeniorPermanent employmentTemporary workFor contractorsWork at officeLocal areaRemote work
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