Remote Behavioral Health Investigator - Fraud & Abuse
$56.2k - $101kCentene Corporation
- Remote job
Centene Corporation is seeking a skilled individual to conduct comprehensive reviews of medical records and claims, focusing on identifying potential fraud, waste, and abuse. The role is remote nationwide and requires a Master’s Degree along with 2+ years of relevant experience in fraud prevention. The position offers competitive pay between $56,200 and $101,000 annually, along with a comprehensive benefits package including health insurance and flexible work arrangements. Join Centene and make a difference in the health of communities across America. #J-18808-Ljbffr Centene Corporation
- Centene Corporation is seeking a remote Fraud Investigator to conduct reviews of medical records and claims to identify fraud and abuse. The role involves analyzing provider billing patterns and preparing recommendations based on findings. A Master’s Degree and relevant...Remote jobFraud
- ...experienced candidate for a remote position that involves conducting... ...and claims to detect fraud, waste, and abuse. The ideal candidate will have... ...as close collaboration with investigators. A broad benefits package is provided, including health insurance and flexible working...Remote jobFraudFlexible hours
$46.99k - $112.2k
CVS Health in Denver is seeking a Fraud Investigation Specialist to conduct high-level analysis related to Pharmacy and Prescriber behavior. This full-time role requires 3-5 years of investigative experience... ...prosecution of Fraud, Waste and Abuse in healthcare. #J-18808-Ljbffr...FraudFull time$46.99k - $112.2k
CVS Health is seeking a dedicated professional to conduct high-level analysis of Pharmacy and Prescriber behavior to prevent fraud and abuse. The ideal candidate will have 3-5 years of investigative experience in healthcare and pharmacy fraud, alongside a Bachelor's degree...FraudFull time$72.8k - $130k
...Fraud, Waste, and Abuse Investigator Optum is a global organization that delivers care, aided by technology... ...with our team will directly improve health outcomes by connecting people with... ...complaints, external intelligence or behavior data, the medical community and law...Remote jobFraudMinimum wageFull timeContract workWork experience placementLocal area$46.99k - $112.2k
...Senior Healthcare Fraud Investigator We're building a world of health around every individual — shaping a more connected, convenient and compassionate health... ...and known acts of healthcare fraud, waste and abuse (FWA). Key Responsibilities Conduct high level...Remote workFraudHourly payFull timeTemporary workWork experience placementLocal areaWork from home$60.2k - $107.4k
...Senior Investigator At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care... ..., investigation and prevention of healthcare fraud, waste and abuse. The Senior Investigator will utilize claims...Remote workFraudMinimum wageFull timeTemporary workWork experience placementLocal areaMonday to Friday$56.2k - $101k
...Position Purpose Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and... ...investigations and coordinate with Health Plans on recommendations and... ...Flexible approach to work with remote, hybrid, field, or office schedules...Remote workFraudWork at officeFlexible hours$56.2k - $101k
...seeking a qualified candidate for a remote role focused on investigating healthcare fraud. You will conduct thorough investigations... ...into potential fraud, waste, and abuse, develop analytical reports, and work collaboratively with Health Plans. To qualify, you should have a...Remote jobFraud$56.2k - $101k
...members. Centene is transforming the health of our communities, one person... ...Purpose Position Purpose: Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing... ...flexible approach to work with remote, hybrid, field or office work...Remote workFraudFull timePart timeWork at officeFlexible hours- Neier Inc. seeks a Technical Abuse Investigator to detect and disrupt malicious use of its platform. Responsibilities... ..., with expertise in domains like AI misuse or fraud, as well as proficiency in SQL and Python. Remote work is available for candidates within the U.S....Remote workFraud
- Point32Health is seeking an Investigator II for the Special Investigation Unit. This role involves leading investigations into fraud, waste, and abuse, requiring a Bachelor's degree and 3-5 years of experience in health insurance or fraud investigations. The Investigator...Remote jobFraud
- ...practice. The Intelligence and Investigations team supports this mission by... .... By precisely understanding abuse, we help ensure OpenAI’s... ...will work PST and is open to remote work within the United States... ...automation; encryption; terrorism; fraud; violence; child exploitation...Remote workFraud
- CVS Health is looking for a Fraud Investigation Specialist in Providence, Rhode Island, responsible for complex analysis of Pharmacy and Prescriber behavior to prevent fraud. The role requires 3-5 years of investigative experience in healthcare and a Bachelor's degree...Fraud
- CVS Health is seeking a Fraud Investigator based in Annapolis, Maryland, to conduct detailed analysis on Pharmacy and Prescriber behavior to prevent fraud. The role requires 3-5 years of investigative experience and knowledge of Pharmacy terminology. Key responsibilities...FraudFull time
$46.99k - $112.2k
CVS Health is seeking a Fraud Investigator in Albany, NY, focused on preventing and investigating healthcare fraud. The role involves analyzing pharmacy behavior and collaborating with law enforcement. Qualified candidates should have 3-5 years of experience in healthcare...Fraud$46.99k - $112.2k
CVS Health in Phoenix, Arizona is seeking a dedicated professional to conduct complex analyses of Pharmacy and Prescriber behavior aimed at preventing fraud. The ideal candidate should have 3-5 years of investigative experience in healthcare fraud, as well as knowledge...FraudFull time$46.99k - $112.2k
CVS Health in Columbus, Ohio is looking for a full-time investigator to tackle complex cases of pharmacy and prescriber fraud, waste, and abuse. This role demands strong analytical skills, investigative experience, and the ability to handle sensitive information while collaborating...FraudFull time- Profile We offer remote work opportunities (AK, AR, AZ, CO, FL... ...adjudicated DOD background investigation for this position. Veterans... ...and reporting of suspected fraud, waste and abuse (FWA) cases as defined by... ...Department of Defense, Defense Health Agency for the TRICARE...Remote workFraudContract workFor subcontractorInterim role
$46.99k - $112.2k
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...FraudFull time$93.5k - $126.5k
...Nurse Analyst / Investigator We are GDIT. As one of the largest IT and mission services... ...to detect and prevent potential fraud, waste or abuse in the Medicare and Medicaid programs.... ...Less than 10% Telecommuting Options: Remote Work Location: Any Location / Remote...Remote workFraudContract workFor contractors$49.7k - $88.8k
Investigator At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The... ...identifying, investigating, and preventing healthcare fraud, waste, and abuse (FWA). This role leverages claims data...Remote jobFraudMinimum wageFull timeTemporary workWork experience placementLocal areaMonday to Friday- ...Pennsylvania Job Title: Behavioral Consultant ABA Location:... ...providing in-community behavioral health support to clients ages 2-21.... ...to pass PA Criminal, Child Abuse, and FBI Clearances • Licensure... ...protected characteristic. Fraud Alert Clarvida never...Remote workFraudFull timeLocal area
$174.07k - $374.92k
...building a world of health around every... ...resources. This is a remote based (work from home... ...supporting SIU Investigators, Managers, and Directors... ...healthcare fraud cases. Provides clinical... ...fraud, waste or abuse. Provides... ...review. Exhibits behaviors outlined in Employee...Remote workFraudFull timeLocal areaWork from home$43 per hour
...Behavioral Consultant Aba Position at Clarvida - Pennsylvania... .../in-community, hybrid/remote) Employment Type: Full-... ...-community behavioral health support to clients ages... ...PA Criminal, Child Abuse, and FBI Clearances... ...protected characteristic. Fraud Alert Clarvida never...Remote workFraudFull timeLocal area- ...Behavioral Health Utilization Manager The Behavioral Health Utilization Manager plays... ...trends for potential indicators of Fraud, Waste, and Abuse (FWA), and take appropriate action when... ...and Physical Demands: Primarily remote role with periodic travel to the Charlestown...Remote workFraudWork at office
$56.2k - $101k
...members. Centene is transforming the health of our communities, one person... ...flexibility. ***POSITION IS REMOTE NATIONWIDE*** ***LOOKING FOR CANDIDATE... ...records to identify potential abuse and fraud and inappropriate billing practices Investigate, analyze, and identify provider...Remote workFraudFull timePart timeWork at officeFlexible hours$58.9k - $80.07k
...Healthfirst is looking for an Investigator within the Special Investigations Unit (SIU) to conduct investigations of alleged misconduct and fraud. This 100% remote role entails compiling data, writing reports, and presenting findings. Candidates must possess an Associate...Remote workFraud$107.7k - $199.3k
...Internal Investigations Manager You could be the one who changes everything... ...Centene is transforming the health of our communities, one... ...Licenses/Certifications: Certified Fraud Investigator preferred Pay... ...approach to work with remote, hybrid, field or office work...Remote workFraudFull timePart timeWork at officeFlexible hours$63k - $84.42k
...Senior Fraud Investigator Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability, and member...Remote workFraudLive inLocal area
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