Senior Healthcare Investigator (Remote) - FWA & Compliance
Optum
- Remote job
UnitedHealth Group is seeking a Senior Investigator to gather and analyze data, determine validity of aberrances, and prepare comprehensive compliance packages. The role supports collaboration with legal, regulators, and external sources. The position requires 5+ years in FWA/SIU, 2+ years in health insurance claims, and up to 25% travel within Ohio. Remote work option is available, with strong emphasis on auditability and data-driven investigations. #J-18808-Ljbffr Optum
- ...Leading complex fraud investigations in healthcare billing, coding, and claims, the full-time remote Senior Fraud Investigator will analyze large data sets to identify patterns... ...are a plus Familiarity with HIPAA, OIG guidelines, and healthcare compliance frameworks...Remote workSeniorFull time
$60.2k - $107.4k
...Job category: Regulatory & Compliance At UnitedHealthcare, we'... ...Growing together. The Senior Investigator is responsible for identification... ...and prevention of healthcare fraud, waste, and abuse. The... ...in fraud, waste and abuse (FWA) investigations/audit ~2+...Remote workSeniorMinimum wageFull timeTemporary workWork experience placementLocal area- ...Centene Corporation seeks an Investigator to conduct fraud, waste, and... ...abuse investigations across healthcare programs. You will review... ...regulatory and contractual compliance. Responsibilities include preparing... ...'s degree and 2+ years in FWA or related fields are...Remote work
- TriWest Healthcare Alliance in Phoenix, AZ is seeking a PI Investigator to identify, analyze, and report suspected fraud, waste and abuse (FWA) within the TRICARE program under DoD contracts. You will... ...confidentiality and compliance with #J-18808-Ljbffr TriWest Healthcare...Remote job
- Centene Corporation is seeking an investigator to conduct fraud, waste, and abuse (FWA) investigations by reviewing referrals, claims data, and medical records... ..., preparing reports, and collaborating with compliance, legal, and external agencies to support corrective...Remote job
$105k
...Business Operations / Strategy; Compliance / Risk / Quality Assurance;... ...incident reporting and investigations, overseeing Electric Operations... ...hybrid, working from your remote office and assigned office based... ...consensus with multiple senior leaders to stay on schedule....Remote workSeniorWork experience placementWork at officeFlexible hours- ...Senior Fraud Investigator Ascensus is the leading independent technology and service platform powering... ...Partner with operations, compliance, legal, technology, and other stakeholders... ...experience preferred For all virtual remote positions, in order to ensure...Remote workSenior
$60.2k - $107.4k
...category: Regulatory & Compliance Optum is a global... ...the flexibility to work remotely* as you take on some... ...articulate behavior through an Investigation Summary and compliance... ...schemes related to FWA to ensure additional... ...(CFE), Accredited Healthcare Fraud Investigator (AHFI...Remote workSeniorMinimum wageFull timeWork experience placementLocal area$60.2k - $107.4k
...Job category: Regulatory & Compliance Optum Insight is improving... ...all relevant facts to drive investigations (30%) Utilize appropriate... ...patterns and schemes related for FWA to ensure additional TIP... ...entities with fraud or healthcare investigations ~ Demonstrated...Remote workSeniorMinimum wageFull timeWork experience placementLocal area- ...Compliance Investigator At Fresenius Medical Care, we are the global leader... ...and care across the entire healthcare journey. Guided by our vision... ...with both junior and senior-level employees, preparing... ...the essential functions. Remote with travel as needed (up to...Remote workWork experience placementLocal areaWorldwideFlexible hours
- ...Highmark Health in Montgomery, AL, seeks an Anti-fraud Investigator to develop and maintain an anti-fraud program, conduct investigations... ...will oversee annual fraud plans, fraud training, and compliance with state regulations, while mentoring other investigators and...Senior
$107.7k - $199.3k
...Corporate Ethics & Compliance Investigator Work Setting: Flexible – Remote, Hybrid, Field or Office schedules may be available... ...Type: Full-time Industry: Healthcare / Managed Care Function: Corporate... ...to work effectively with senior leadership, legal counsel, compliance...Remote workFull timeWork at officeFlexible hours- ...CA invites applications for the Special Investigations Investigator, Consultant role in our SIU. You will conduct investigations into healthcare fraud, waste, and abuse, report findings to the SIU manager, and ensure compliance with policies and laws. The position requires...SeniorWork at office2 days per week
- ...Highmark Health seeks a dedicated investigator to develop and maintain an anti-fraud program, conduct investigations into fraud, waste... ...and support recovery of misappropriated funds while ensuring compliance with internal audits and regulatory standards. #J-18808-Ljbffr...Senior
- ...and maintain an anti-fraud program, conduct investigations of fraud, waste and abuse, and coordinate with... ...recover misappropriated funds while ensuring compliance with internal audits and state regulations. This is a senior, office-based role with travel to sites as required...SeniorWork at office
$115k - $165k
...University of California - Los Angeles Health is seeking a Senior Compliance Investigator to lead compliance investigations involving potential... ...relevant experience, strong analytical skills, and knowledge of healthcare regulations. Responsibilities include gathering and...Senior$65k - $88.6k
...Humana is looking for an experienced Healthcare Investigator to join its industry leading Special Investigations... ...a thorough investigation to maintain compliance with Humana and governmental... .... Travel: While this is a remote position, occasional travel to Humana'...Remote workFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome office- ...Centene Corp. seeks an SIU Investigator to conduct fraud, waste and abuse investigations across... ...support case resolution and regulatory compliance. The role favors candidates residing in... ...visa sponsorship now or in the future. Remote options are available within the U.S....Remote workVisa sponsorship
- Medica is seeking an SIU Investigator III to join our Minnetonka, MN office. This onsite role conducts complex fraud, waste and abuse investigations... ...partners to advance investigations and ensure regulatory compliance. The ideal candidate holds a Bachelor's degree in a related...SeniorWork at office
- ...immigrants in the U.S. in a hybrid role based in Miami. We seek a Senior Fraud Analyst for Consumer Lending to protect unit economics of... ...fraud typologies, own analytics, and work with Operations, Compliance, and Engineering to keep growth secure and profitable. #J-1880...Remote jobSenior
$500 per month
...Senior Fraud Analyst – Fraud Investigations & Financial Crimes Monitoring Remote - North America Alpaca is a US-headquartered, global leader in agent-first brokerage... ...Securities' dynamic and fully remote Compliance team dedicated to safeguarding the integrity...Remote workSeniorHome office- Conducting detailed investigations into potential fraud, waste, and abuse in healthcare claims, the full-time remote Special Investigator will review medical records and claims... ..., and prepare comprehensive reports for compliance and recovery actions. Key responsibilities...Remote workFull time
- Senior Director of Operations (HUB & Access Programs) Location: RemoteLead... ...a growing portfolio of healthcare programs.Why You Should... ...at the enterprise levelFully remote leadership opportunityInfluence... ...performance, SOWs, renewals, compliance, revenue, and marginDrive cross...Remote workSenior
- ...To support advanced AI workloads in a healthcare environment, the fully remote Senior Azure Cloud Infrastructure Engineer will design, build, and operate... ...a resilient, secure cloud platform while ensuring compliance and optimizing performance and costs. Key responsibilities...Remote workSenior
- ...today. About the Role As our Senior Fraud Analyst for Consumer... ...automated block and manual investigation policies. Advanced Risk Tooling... ...workflows. Regulatory & Compliance Liaison: Coordinate with the... ...Health, dental, and vision plans Remote work environment, although...Remote workSenior
- A healthcare consulting firm is seeking a Senior Privacy Consultant for a 3-month contract starting in October. This remote position involves leading privacy engagements, assessing environments, and guiding clients on compliance matters. Ideal candidates should have over...Remote jobSeniorContract work
- A healthcare organization in Downers Grove is seeking a Sr Lease Administrator to oversee lease processes and compliance. This role requires 5+ years of experience in commercial lease administration and involves managing third-party vendors. Strong communication skills...Remote jobSenior
- ...Do you enjoy working in a fast-pace d Remote-Centered envi ronment with variety in your... ...of Insurance (CDI) is seeking a dynamic Senior Insurance Examiner (Supervisor) to... ...within 30 days of physical separation. Non-compliance with the Conflict of Interest Code requirements...Remote workSeniorFull timeWork at officeFlexible hoursShift work
$85k - $97.5k
Summary The Senior Fraud Analyst supports the Credit Union’s digital... ...program by monitoring, investigating, analyzing, and escalating fraud... ..., digital account opening, remote deposit capture, card‑not‑... ..., Cybersecurity, Payments, Compliance, and BSA/AML during fraud investigations...Remote workSeniorFull timePart timeWork at officeFlexible hours- ...management, with opportunities in acquisitions and governance. The ideal candidate will translate complex legal issues for business partners, travel as needed, and contribute to BAYADA’s commitment to care and compliance across offices. #J-18808-Ljbffr BAYADA Home Health CareRemote jobSenior
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior Healthcare Investigator (Remote) - FWA & Compliance. Be the first to apply!
- housing investigator Dublin, OH
- senior customer service Dublin, OH
- senior manager Dublin, OH
- senior living Dublin, OH
- senior real estate accountant Dublin, OH
- remote senior project manager Dublin, OH
- senior Dublin, OH
- senior software engineer remote Dublin, OH
- senior tax Dublin, OH
- senior accountant Dublin, OH



