Senior Investigator, Fraud & Abuse — Special Investigations
$46.99k - $112.2kCVS
CVS Health is seeking an experienced investigator in Raleigh to conduct complex analyses of Pharmacy and Prescriber behaviors aimed at preventing fraud. The candidate should have experience in healthcare fraud investigations and proficiency in data analysis. This full-time position offers a competitive salary range between $46,988.00 and $112,200.00 along with a comprehensive benefits package, including medical, dental, and vision coverage. #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...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- CVS Health, including Meritain Health, seeks an SIU Investigator to join the Network Cost Management team. You will conduct investigations to prevent and pursue healthcare fraud, recover funds, and ensure compliance with state regulations. The role requires collaboration...SeniorFraud
$46.99k - $122.4k
CVS Health is seeking a full-time Healthcare Fraud Investigator located in North Carolina. This role involves managing complex fraud cases, investigating fraudulent claims, and preparing documentation for legal review. Candidates should possess a Bachelor's degree or equivalent...SeniorFraudFull time- ...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 for...FraudLocal areaNight shiftWeekend work
$107.7k - $199.3k
...sensitive, and high-impact internal investigations across the organization.... ...and the ability to influence senior leadership decisions while... .... Participates in and leads special projects (e.g., auditing, training... .../Certifications Certified Fraud Investigator preferred. Pay...FraudFull timePart timeWork at officeRemote workFlexible hours- Centene Corporation is seeking a skilled Investigator to lead complex internal investigations and ensure compliance with laws and regulations. This role involves evaluating allegations, conducting interviews, and managing investigation strategies. The ideal candidate will...SeniorRemote jobFlexible hours
$70.35k - $205.8k
We Are: Accenture Security is one of the fastest growing areas of our business, and our global Cyber Investigation and Forensic Response (CIFR) practice is at the heart of how we help clients prepare for, respond to, and recover from the most consequential cyber incidents...SeniorWork experience placementLive inWork at officeLocal area- Practical Adult Insights is seeking an Insurance Fraud Investigator in North Carolina to evaluate insurance claims and verify their authenticity. This position entails collecting information about claimants, conducting surveillance, and documenting findings clearly. The...Fraud
$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$50.63k - $88.61k
...State Auditor (OSA) is seeking an Investigative Analyst to assist the Special Investigations Division by... ...complaints related to government waste, abuse, and fraud. OSA is the state’s Fiscal... ...combination of education and experience Seniority level Seniority level Associate...FraudFull timeTemporary workWork at officeLocal areaFlexible hours- ...Jobtailor is seeking a Fraud Analyst to support monitoring of customer financial accounts and investigate potential fraudulent activity. The role involves addressing fraud concerns from clients and associates, escalating suspicious activity, and providing first-line investigation...Fraud
- ...What we are looking for The Quality Investigator will be operating in full compliance with applicable hygiene, safety, quality, and regulatory standards, and in alignment with the organization’s framework, company’s procedures, and the defined scope of responsibility...Local area
- ...primary divisions that carry out regulatory enforcement, promotional programs, and administrative operations. The Wage and Hour Investigator I (S) works to achieve compliance with the Wage and Hour Act, E-Verify Act, Controlled Substance Examination Regulation Act, Expunction...Work at office
- ...Whitley Law Firm is a dynamic and fast-paced plaintiff’s personal injury law firm. We are seeking a dedicated and experienced Investigator committed to advocating for our clients. With a proven record of excellence in client service, individualized attention and delivering...Full timeTemporary workWork at officeRemote workMonday to Friday
- ...Accentuate Staffing is partnering with a leading pharmaceutical manufacturing company that is hiring for a Quality Investigator. This is a contract opportunity with potential for hire, offering competitive pay and the opportunity to work in a highly regulated GMP manufacturing...Contract workWork at office
$45 - $49 per hour
...Job Title: Quality Investigator The Quality Investigator is an individual contributor role within the QA Compliance department. This position requires collaboration across various plant functions to ensure quality and compliance standards are upheld. Responsibilities...Contract workTemporary workMonday to FridayDay shiftWeekday work- ...insurance agents, adjusters, bail bondsmen and more, along with investigating fraud matters involving insurance consumers and any entity or... ...equivalent combination of training and experience. Necessary Special Qualifications: The Investigative Specialist must pass...FraudWork at officeFlexible hours
- ...Accenture is hiring a Cyber Investigation leader in Raleigh, North Carolina. In this role, you will conduct complex forensic analyses and lead incident response efforts. You'll mentor junior team members and interface directly with clients to ensure effective communication...
- ...About the Role Employee Benefits Corporation is hiring for a Fraud Prevention Analyst. In this role, you’ll help protect EBC and... ...fraud risks across our products and operations. You’ll combine investigation, analytics, and risk management to uncover patterns, strengthen...FraudWork at officeRemote workFlexible hours
$42 - $49 per hour
...Degree in related field 3-5 years of experience in deviations investigations in pharmaceutical or biotechnology industries Ability to... ...change controls, training, inspection preparation activities. Seniority level Mid-Senior level Employment type Contract Job function...Contract work- The Office of Intramural Training & Education seeks a Tenure-Track Investigator to develop independent research on environmental exposure and aging-related diseases at the NIEHS in Research Triangle Park, NC. The ideal candidate will have a Ph.D. or M.D. and experience...Work at office
$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- Employee Benefits Corporation is seeking a Fraud Prevention Analyst to identify and respond to fraud risks across products and operations. This role involves investigation, analytics, and risk management, providing actionable insights to prevent fraud. Applicants should...FraudRemote job
$45 - $49 per hour
...Job Description Job Description Job Title: Quality Investigator Job Description The Quality Investigator serves as an individual... ...their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With...Contract workTemporary workImmediate startMonday to FridayWeekend workDay shift- ...Chapel Hill is looking for a data analyst/statistician at or above the master’s degree level, to work in a collaborative team of investigators and perform statistical analyses to gain new discoveries to help trauma survivors. The primary focus of the position will be to...Full timeTemporary workPart timeWork at officeImmediate start
- ...this position is responsible for conducting initial reviews of fraud alerts and notifications received from internal systems,... ...of potential fraud cases and escalates those requiring further investigation to the appropriate team. This role plays a critical part in early...FraudLive outWork at office
- ...Job Description As the Senior Category Manager, you will lead sourcing and vendor governance... ..., including those that require specialized subject matter expertise, nonstandard risk... ...Management, Vendor Risk Management Job Alert Fraud We have become aware of scams from...SeniorFraudWork at officeLocal areaRemote workFlexible hours2 days per week
$28 - $32 per hour
Description Command Investigations, LLC is seeking an Insurance Field Investigator with a minimum of three years experience to become part... ...recorders and cameras, with proficiency and accuracy Special Note This role requires you to supply your own equipment, including...Hourly payFull timePart timeWork at officeRemote workFlexible hours- ...results in a manner appropriate for both senior executive and management review.... ...factors including experience and training, specialized skill sets, licensure and certifications... ...performance. 81,068.00 - 129,708.00 JOB ALERT FRAUD: We have become aware of scams from...SeniorFraudWork at officeLocal areaRemote workFlexible hours2 days per week
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