Senior Investigator, Healthcare Fraud & Compliance
EmblemHealth
A leading healthcare organization in New York is seeking an experienced Fraud Investigator to conduct complex investigations of reported fraud. The ideal candidate will maintain regulatory agency relationships and provide guidance to the Fraud Investigators. They should have a bachelor's degree in criminal justice or a related field, with 4 to 6+ years of relevant experience. Strong knowledge of medical coding, MS Office proficiency, and exceptional communication skills are required. #J-18808-Ljbffr
$70k - $90k
...Cotiviti is seeking a Senior Investigator to support the post-pay Fraud Waste & Abuse team. In this role, you will analyze incidents of fraud, manage investigations, and interact with various stakeholders. A Bachelor’s Degree along with 5-8 years of investigative experience...SeniorFraudRemote work$70k - $90k
...A leading healthcare analytics firm is seeking a Senior Investigator to investigate incidents of healthcare fraud, waste, and abuse through data analysis. This remote position requires a Bachelor's degree, 5-8 years of experience in healthcare FWA investigations, and advanced...SeniorFraudRemote work- ...Summary of Job Conduct complex, in-depth investigations of reported fraud involving the full range of healthcare products. Develop and maintain relationships with law enforcement (HHS-OIG, FBI, DOJ), regulatory agencies (DFS, MEDIC, OMIG, MFCU) and with industry peers....SeniorFraudWork experience placementRemote work
$70k - $90k
...Overview As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis (a high level of proficiency with... ...Forensic Interviewer (CFI) Certified in Healthcare Compliance (CHC) Job Demands This is a work-at-home...SeniorFraudWork experience placementWork at officeWork from home- ...provider based in New York is seeking an experienced ACE Investigator to assist with federal fraud investigations. This role requires extensive knowledge... ...candidate will support the investigation of fraud in healthcare, contracting, and grants. Competitive benefits are...SeniorFraud
- CVS Health in Pennsylvania is seeking a skilled professional to manage complex cases involving health care fraud. The candidate will investigate claims, collaborate with law enforcement, and ensure adherence to health care regulations. Interested individuals must hold a...SeniorFraudFull timeWork at office
$46.99k - $122.4k
CVS Health is seeking an experienced professional for a full-time role in health care fraud investigations in United States, Kentucky. The position requires a minimum of 3 years of experience in related fields and knowledge of health care coding systems. This role offers...SeniorFraudFull time- A healthcare company in New York is seeking a Fraud Investigator to conduct in-depth investigations of reported fraud. Responsibilities include mentoring other investigators, investigating Medicaid fraud cases, and maintaining relationships with law enforcement. Candidates...SeniorFraud
- CVS Health is seeking a qualified professional to manage health care fraud investigations. This role requires expertise in CPT/HCPCS/ICD coding and 3 years of experience in fraud investigations. You will investigate cases, document findings, and participate in legal proceedings...SeniorFraudFull time
- ...Mid-Level Department: Litigation Support CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project... ...qualifications Relevant Healthcare Fraud experience including compliance, auditing duties, and other duties in Section 3 Relevant...FraudFull timeWork experience placementWork at officeLocal area
- ...Senior Counsel, Commercial Healthcare About the Company Regulated healthcare organization Industry... ...will also be responsible for ensuring compliance with healthcare and consumer... ...specific regulatory issues, such as fraud and abuse considerations, advertising...SeniorFraud
$187k - $253k
...are seeking a brilliant and passionate Senior Staff Analyst for Fraud Policy to be a key player in... ...minimizing fraud losses and maintaining compliance with applicable regulations. Responsibilities Fraud Detection & Investigation Monitor alerts and analyze real-time...SeniorFraudRemote work$60.2k - $107.4k
A leading health care organization is looking for a Senior Investigator Pharmacy to tackle healthcare fraud, waste, and abuse. The role includes investigating complex cases and preparing detailed reports based on findings. Candidates must have a Bachelor's or Associate'...SeniorFraud$60.2k - $107.4k
Senior Investigator Pharmacy At UnitedHealthcare, we're simplifying the health care experience... ...identification, investigation and prevention of healthcare fraud, waste and abuse. The investigator... ..., waste and abuse referrals Ensure compliance with applicable federal/state...SeniorFraudFull timeTemporary workWork experience placementLocal areaRemote work$161.6k - $202k
...is to fix this by building a new mental healthcare system everyone can access. We started by... ...responsibility demands a security and compliance program that scales with the business. We... ...yourself against phishing and recruitment fraud, please note that Headway only accepts...SeniorFraudWork from homeFlexible hours$179.2k - $280k
...is building a new mental healthcare system that everyone can... ...healthcare for the better. As Senior Counsel, Labor &... ...leaves and accommodations, investigations, wage and hour compliance, and other key areas. Build... ...phishing and recruitment fraud, please note that Headway...SeniorFraudWork from homeFlexible hours- ...billion of private equity healthcare transactions. As we scale our... ...50 states, we're seeking a Senior Compliance Analyst to ensure our legal... ...for new Brand Partners Investigate potential compliance violations... ...opinions and healthcare fraud enforcement trends Skills &...SeniorFraudRemote workFlexible hours
$128.7k - $153.4k
...technology solutions in civic healthcare. Our dedication lies in... ...integrity efforts to combat fraud, waste, and abuse within Medicare... ...case tracking, audits, investigations, and workload management. UCM... ...to prevent fraud and ensure compliance through efficient lead management...SeniorFraudTemporary workFor contractorsRemote workWork from homeFlexible hours- The Office of the NYS Comptroller Thomas P. DiNapoli is seeking an Investigator to direct and conduct confidential investigations regarding fraud, waste, and abuse. Candidates should possess at least 8 years of experience as a Police or Peace Officer and significant experience...SeniorFraudWork at officeRemote work
$59.88k - $95.7k
Position Title Fraud Investigator Sr Location Troy, MI 48098 Job Summary The Enterprise Fraud Investigator Sr is responsible for conducting... ...responsibilities as required. Consistently adheres to regulatory and compliance policies and standards linked to the job as listed and...SeniorFraudFull timeWork experience placementWork at officeLocal area$84k - $105k
...scores, and decision‑making logic from both internal and external fraud‑risk models and applications, and for ensuring an optimal... ...year. Additional incentives and benefits available. Benefits Healthcare Coverage - competitive medical (PPO/HDHP), dental, and vision plans...SeniorFraudWork at officeVisa sponsorshipWork visaFlexible hours$194k - $235k
...that lacks personalization, behavioral healthcare can leave people feeling unseen and unsupported... ...Privacy & Data Governance Oversee compliance with HIPAA/HITECH, CCPA/CPRA, and state... ...and bias laws, AKS, FCA and other fraud and abuse laws Partner closely with Product...SeniorFraudFull timeFixed term contractWork at officeLocal area$79.52k
A government law enforcement agency in New York seeks a Senior Rackets Investigator for its Worker Protection Unit. The role involves conducting investigations into worker exploitation, collaborating with community groups, and preparing reports. Candidates must have relevant...SeniorFraud$84k - $105k
...decisioning logic from both internally and externally developed fraud risk models and applications with the associated outcomes as it... ...for a discretionary incentive plan and benefits. Benefits Healthcare Coverage - Competitive medical (PPO/HDHP), dental, and vision plans...SeniorFraudHourly payWork at officeImmediate startVisa sponsorshipWork visaFlexible hours- HRA/DEPT OF SOCIAL SERVICES in New York is seeking a Fraud Investigator II to conduct detailed investigations of IDNYC applicants' documents. This role requires a four-year high school diploma and three years of experience in investigations involving criminal activities...SeniorFraudFlexible hoursAfternoon shift
- ...RELX INC is seeking a Senior Fraud Analyst responsible for providing investigative and analytical support to clients. This role involves analyzing data, developing methodologies to assess risk, and utilizing SQL and programming skills. A Bachelor's degree and 5+ years...SeniorFraudRemote work
$74.44k
...Queens County District Attorney (QDA) is seeking candidates for Senior Rackets Investigator positions within QDA's Detective Investigator Squad, which... ..., domestic violence, gangs, public integrity, governmental fraud, revenue crimes, cyber crimes, white collar crimes,...SeniorFraudFull timeWork at office- Responsibilities Conducts investigations into allegations of fraud, waste, or abuse, including preliminary assessments and full end-to-end case work... ...field. Certified Professional Coder (CPC), Accredited Healthcare Fraud Investigator (AFHI), Certified Insurance Fraud...SeniorFraudWork at office
$86.8k - $117.6k
...Victorias Secret Co is looking for a Sr Investigator, Ethics & Compliance to conduct thorough investigations of company policy violations. This remote full-time role requires at least 5-7 years of experience in HR investigations and offers a salary range from $86,800 to...SeniorFull timeRemote work- ...this mission, the BXDA seeks an experienced and enthusiastic Senior Rackets Investigator. The Senior Investigator is responsible for conducting a... ...preferred: homicides, robberies, grand larceny, financial crimes, fraud, and identity theft. As per NY Public Officers Law 2, 3-B,...SeniorFraudFull timeWork at officeWeekend workAfternoon shift
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