• Criminal Investigator

    State of Georgia (Fulton County, GA)
    Criminal Investigator - Medicaid Fraud Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/73115/other-jobs-matching/location-only) Hot ... through this announcement will serve in the Investigations section of our Medicaid Fraud Division. Duties & Responsibilities: Investigators conduct health care… more
    State of Georgia (10/10/25)
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  • Law Enforcement Investigator II - 1

    MyFlorida (Pensacola, FL)
    … II position is in the Office of the Attorney General within the Medicaid Fraud Control Unit in Pensacola, Florida. Pay:$60,000.20 - $62,425.00 Annually ... healthcare fraud investigative experience working in a Medicaid Fraud Control Unit, or five (5)...the Medicaid Program, false claims against the Medicaid program, investigating possible criminal violations of… more
    MyFlorida (12/11/25)
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  • Senior Investigator - 1 1

    MyFlorida (Miami, FL)
    SENIOR INVESTIGATOR - 41000681 1 1 Date: Dec 8, 2025...in the Office of the Attorney General within the Medicaid Fraud Control Unit in Miami, Florida. Pay: ... Agency: Office of the Attorney General Working Title: SENIOR INVESTIGATOR - 41000681 1 1 Pay Plan: Career Service...or who have prior investigative work experience in a Medicaid Fraud Control Unit and/or 5 years… more
    MyFlorida (12/09/25)
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  • Investigator /Special Agent 1-4

    Louisiana Department of State Civil Service (LA)
    …and provides investigative services in cybercrimes, white collar crimes, and public corruption. Medicaid Fraud Control Unit: The Louisiana Medicaid Fraud ... other Medicaid providers. The MFCU holds offenders accountable through criminal prosecution and civil litigation. From inception through disposition, the nurse… more
    Louisiana Department of State Civil Service (11/18/25)
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  • Medical Investigator I/II (RN Required)

    Excellus BlueCross BlueShield (Rochester, NY)
    …this position is responsible for the accurate and thorough clinical investigation of potential fraud , waste and abuse (FWA) for all lines of business. The scope of ... + Prepares recommendations on preventive/corrective measures for the deterrent of future fraud . + Supports other SIU investigators and analysts with their cases by… more
    Excellus BlueCross BlueShield (12/17/25)
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  • Special Investigator

    AmeriHealth Caritas (Columbia, SC)
    …services. Discover more about us at www.amerihealthcaritas.com. The Investigator is responsible for conducting comprehensive investigations of reported, ... alleged or suspected fraud involving the full range of products at the...information which would be considered admissible under generally accepted criminal and civil rules of evidence. + Proactively performs… more
    AmeriHealth Caritas (12/03/25)
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  • Intake Coordinator- Medicaid Fraud

    State of Georgia (Fulton County, GA)
    Intake Coordinator- Medicaid Fraud Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/72587/other-jobs-matching/location-only) Hot ... announcement will serve in the Investigations Section of our Medicaid Fraud & Patient Protection Division. Duties...procedures; (2) state laws and rules governing the Georgia Medicaid program; and (3) criminal laws and… more
    State of Georgia (12/26/25)
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  • Senior Investigator , Aetna SIU (Must…

    CVS Health (Columbus, OH)
    …it all with heart, each and every day. **Position Summary** As a Senior Investigator you will conduct high level, complex investigations of known or suspected acts ... of healthcare fraud and abuse. Routinely handles cases that are sensitive...to prevent payment of fraudulent claims submitted to the Medicaid lines of business + Researches and prepares cases… more
    CVS Health (12/20/25)
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  • Lead SIU Investigator

    Centene Corporation (Frankfort, KY)
    …A license in one of the following is required: Other Accredited Health Care Fraud Investigator (AHFI) or Certified Fraud Examiner (CFE). Other Pharmacy ... as a subject matter expert for the Contractor's Program Integrity unit to reduce Fraud , Waste and Abuse of Medicaid services within Kentucky. Provides direction… more
    Centene Corporation (12/10/25)
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  • Clinical Investigator

    MVP Health Care (Tarrytown, NY)
    …thinking and continuous improvement. To achieve this, we're looking for a **Clinical Investigator ** to join #TeamMVP. This is the opportunity for you if you have ... Workplace** . **Qualifications you'll bring:** + BA/BS degree in criminal justice or a related field, and minimum of...involving economic or insurance related matters. + A clinical investigator must have in addition to the above requirements:… more
    MVP Health Care (12/02/25)
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  • Lead Investigator , Special Investigative…

    Molina Healthcare (Covington, KY)
    …according to the SIU's standards. Position must have thorough knowledge of Medicaid /Medicare/Marketplace health coverage audit policies and be able to apply them in ... position must have the ability to determine correct coding, documentation, potential fraud , abuse, and over utilization by providers and recipients. The position… more
    Molina Healthcare (11/21/25)
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  • Ops Government Analyst II

    MyFlorida (Tallahassee, FL)
    …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator ; Certified ... is to ensure fewer budgeted dollars are lost to fraud , abuse, and waste. The Bureau of Medicaid...Financial Crimes Investigator ; Certified Insurance Fraud Investigator ; or Certified Compliance and Ethics… more
    MyFlorida (12/17/25)
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  • Audit Evaluation & Review Analyst - 1

    MyFlorida (Tampa, FL)
    …30% Serve as lead investigator on cases involving suspected Cost Report Fraud and Prospective Payment System Medicaid provider fraud involving: 1) ... in the Office of the Attorney General within the Medicaid Fraud Control Unit in Tampa, Florida...or Orlando Florida, and involves auditing complex multi-million-dollar healthcare fraud investigations that can result in criminal more
    MyFlorida (12/05/25)
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