Remote Healthcare Investigator - HCBS Compliance & Risk
Simple Staffing
Staffing Solutions Organization LLC is seeking a Healthcare Investigator I to conduct thorough investigations into incidents involving Medicaid recipients and providers, ensuring health and welfare standards are met. This fully remote role supports collaboration with law enforcement, social services, and regulatory agencies within Ohio. The ideal candidate holds an Ohio RN, LSW/LISW, or LPC/LPCC license, with at least one year of HCBS experience, and demonstrates strong analytical and #J-18808-Ljbffr
- ...Integra Partners is seeking a Compliance Analyst to be an integral member... ...You will monitor for FWA issues, investigate and audit provider billing and... ...CMS alerts, manage compliance risks, and ensure timely audits of vendors and healthcare providers within the network. #J...Remote workRisk
- ...Providing investigative support for special investigation... ...activities, the full-time Healthcare Fraud Investigator... ...abuse, while working remotely. Key responsibilities... ...external review, ensuring compliance with regulations... ...analyze and determine risk objectively Understanding...Remote workRiskFull time
$65k - $88.6k
...conducting comprehensive investigations of reported, alleged... ...Analyze healthcare payment methodologies,... ...documentation integrity, and compliance with applicable policies... ...and areas of potential risk. preserve evidence and... ...Work Style Fully remote in the contiguous US,...Remote workRiskFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday- ...Senior Healthcare Fraud InvestigatorArlo Solutions is... ...Office of Integrity and Compliance (OIC) in standing up and... ...data analytics, fraud risk assessment and fast... ...Government personnel.Location: REMOTE - Local to Washington,... ..., and standard investigation templates.Overpayment...Remote workRiskContract workFor contractorsWork at officeLocal area
- ...visibility Fraud Rapid Response Center through a 100% remote work arrangement. The role focuses on detecting and responding to healthcare FWA while safeguarding taxpayer dollars. The Analyst will develop evidence packages, risk assessments, and SOPs, coordinating with VA...Remote workRisk
- ...seeking a Licensed Professional Counselor to join our remote Healthcare Investigator team in Ohio. The role conducts investigations... ...documentation, interviews involved parties, and ensures compliance with Ohio Medicaid and HCBS regulations. You will work independently from...Remote workLocal areaWork from home
- ...Remote – Must be a licensed LSW, RN, or LPC... ...Are you a licensed healthcare professional who’s... ...’s Medicaid and HCBS programs. Position... ...Summary: The Healthcare Investigator plays a critical... ...providers, assess compliance with Ohio Medicaid... ...factors, and risks; prepare clear, well...Remote workRiskWork from homeFlexible hours
$63.3k - $114.3k
...responsible for conducting internal investigations of concerns of misconduct or... ...areas identified as moderate risk in the annual risk assessment... ...the Corporate Integrity and Compliance Program and regulations.... ...role: 3 days in office; 2 days remote. Pay Transparency Statement...Remote workRiskWork experience placementWork at officeFlexible hours3 days per week$53k - $55k
...Licensed Social Worker - Healthcare Investigator - State of Ohio Work Location: Remote – Must be a licensed as an... ...stakeholders, and ensures compliance with Ohio Medicaid and HCBS regulations. Essential... ...factors, and potential risks; develops clear, well‑supported...Remote workRiskH1bWork at officeWork from homeFlexible hours$36.43 - $44.04 per hour
Title: Senior Investigator State Role Title: Health Care Compliance Spec II Hiring Range: $36.43-$44.0... ...citizens of the Commonwealth. Healthcare licensees with... ...work and to maintain a remote office with high speed Internet... ...not limited to fraud; risk management; quality assurance...Remote workRiskWork experience placementWork at officeNight shift- Staffing Solutions Organization LLC is seeking a fully remote Healthcare Investigator licensed in Ohio (RN, LSW/LISW, or LPC/LPCC) to safeguard Medicaid... ...confidentiality, independent work, and adherence to HCBS and Medicaid regulations, with occasional training travel...Remote job
$30 per hour
...Compliance Investigator Pittsfield, MA | $30.00 per hour | Full-Time | Temporary Assignment Through December... ..., audits, quality assurance reviews, risk assessments, or closely related work.... ...Pittsfield, MA. Potential for a hybrid/remote work arrangement after successful...Remote workRiskHourly payFull timeTemporary workWork at officeMonday to FridayAfternoon shiftEarly shift- ...marketplace that connects healthcare professionals with the workplaces... ...Founded in 2016, we are a remote-first team of over 1,000... ...safe. What You’ll Do Investigate safety incidents end-to-end... ...outcomes. Assess safety and compliance risks; design strategies to close...Remote workRisk
$100k - $165k
...Francisco / CaliforniaCompliance - Compliance Programs & Strategy /Full-... ...Crimes team as a Blockchain Investigator. This role will assist the... ...update controls and mitigate risks. The successful candidate will... ...in one of our hub-cities or remote and report to the VP of Compliance...Remote workRiskFull timeLocal area- ...seeking a Senior Financial Crimes Investigator to detect suspicious activity... ...SARs, and ensure AML/KYC compliance. You may lead investigations... ...clients to manage financial crime risks. This role offers... ...fast-paced environment with remote work from your home address and...Remote workRiskWork from home
- ...Health in Grants Pass, Oregon is seeking a Compliance Specialist to support the enterprise-... ...the Chief Compliance Officer with investigations, policies, training, and reporting. Responsibilities... ..., maintaining confidentiality, and aiding in risk assessments. #J-18808-Ljbffr...Risk
$105k
...Category: Business Operations / Strategy; Compliance / Risk / Quality Assurance; Engineering /... ...including through incident reporting and investigations, overseeing Electric Operations and... ...position is hybrid, working from your remote office and assigned office based on business...Remote workRiskWork experience placementWork at officeFlexible hours- ...Position SummaryThe Senior Fraud Investigator is a senior individual... ...contributing to broader fraud risk strategies. In addition to conducting... ...with operations, compliance, legal, technology, and other... ...experience preferredFor all virtual remote positions, in order to ensure...Remote workRiskFull timeSecond job
$107.7k - $199.3k
...Principal Compliance Investigator – Centene Corporation Join us to change the... ...regulatory compliance, and risk mitigation. Apply exceptional... ...Justice, Criminology, Law, Healthcare Administration/Health... ...flexible approach to work with remote, hybrid, field or office schedules...Remote workRiskFull timeWork at officeFlexible hours- ...senior level support for complex analysis and investigations to identify, assess, and mitigate insider risks affecting Molina Healthcare’s employees, members, operations, systems,... ...Partners with Human Resources, Legal, Compliance, Privacy, Information Security, Corporate...Remote workRiskFull time
- ...reviews of medical records and claims, the full-time remote Behavioral Health Investigator (MO Licensed) will support the Special... ...identifying potential overpayments and suspected healthcare fraud while ensuring compliance with coding and billing regulations. Key responsibilities...Remote workFull time
- ...is seeking a Senior Financial Crimes Investigator for a remote role in the United States. You will detect... ...activity, ensure regulatory compliance, lead investigations, and may supervise... ...coordinating with clients to mitigate AML risks. The position emphasizes KYC...Remote workRiskHome office
$250k - $290k
...biomedical research and transform healthcare. We are seeking a Director-level Principal Investigator to establish and lead our AI... ...three complementary areas: health-risk prediction, developing... ...individual over their location, and remote or non-Bay-Area arrangements are...Remote workRiskLocal area- ...Scope of Work The Disease Investigator will contact those diagnosed with... ...or assist with workplace and healthcare facility notification and... ...compatible with telecommuting or remote work. All positions are on‑... ...to healthcare facilities if risk was present. Provide guidance...Remote workRiskFor contractorsWork experience placementWork at office
$56.2k - $101k
...fraud, waste, and abuse (FWA) investigations by reviewing referrals,... ...integrity efforts while ensuring compliance with applicable laws,... ...and trends that may present risks to healthcare programs and recommend appropriate... ...approach to work with remote, hybrid, field or office...Remote workRiskFull timePart timeWork at officeFlexible hours$65k
...The Opportunity The Fraud Investigator plays a critical role in protecting... ...provide recommendations for risk mitigation, and ensure timely... ...cases efficiently and in compliance with regulatory standards.... .... How We Work Nymbus is a remote-first company. Success in our...Remote workRiskWork at officeLocal areaFlexible hours$27.5 - $29.17 per hour
...Discrimination Law Investigator FT / PT Status – Full-Time Salary – $27.50 - $29.17 Hourly Wage Remote Work / In-Office – Hybrid Application... ...interpretations of law, and compliance with state and federal standards... ...for promotions/transfers. Risks found in the typical office...Remote workRiskHourly payFull timeWork at office- ...UnitedHealth Group is seeking a Senior Investigator to gather and analyze data, determine validity... ...aberrances, and prepare comprehensive compliance packages. The role supports... ...claims, and up to 25% travel within Ohio. Remote work option is available, with strong emphasis...Remote work
- ...LLC is seeking a Senior Financial Crimes Investigator to detect suspicious activity, ensure regulatory compliance, and lead investigations. The role offers... ...collaboration with clients to manage financial crime risks. The position is remote with core hours and training, requiring...Remote jobRisk
- ...Description Summary: The Sub Investigator (NP or PA-C) plays a... ...research studies within the healthcare sector. This position involves... ...to ensure the integrity and compliance of clinical trials, while providing... ...regarding study procedures, risks, and benefits to ensure...RiskH1b
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