- 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
- Humana (Oklahoma City, OK)
- …Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the Oklahoma Medicaid Team. This team of Investigators conducts ... Medicaid line of business. As the Senior Fraud and Waste Investigator , you will serve...contact for OHCA and other agencies such as the Medicaid Fraud Control Unit (MFCU) and coordinate… more
- Humana (Santa Fe, NM)
- …of situations or data requires an in-depth evaluation of variable factors. The Fraud and Waste Investigator collaborates in investigations with law enforcement ... health first** Humana is looking for an experienced Healthcare Investigator to join its industry leading Special Investigations Unit....of all do you have a passion for combating Fraud , Waste, and Abuse in the Health Care Industry?… more
- Humana (Lincoln, NE)
- …2 is responsible for conducting comprehensive investigations of reported, alleged or suspected fraud involving Florida's Medicaid Program. The Fraud and ... to include multiple practice areas + At least 2 years of healthcare fraud investigations and auditing experience + Knowledge of healthcare payment methodologies +… more
- 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 ... LAW ENFORCEMENT INVESTIGATOR II - 41001250 1 Date: Dec 10,...healthcare fraud investigative experience working in a Medicaid Fraud Control Unit, or five (5)… more
- 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
- 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 ... Investigator /Special Agent 1-4 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/5143725) Apply Investigator /Special Agent 1-4 Salary… more
- 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
- 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...lieu of formal educational requirements for the Lead SIU Investigator position may be considered. + Valid driver's license… more
- 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...experience but an interest in progressing to be an Investigator with the Division. MAJOR WORKER CHARACTERISTICS . Knowledge… more
- 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
- 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 ... expert for the Contractor's Program Integrity unit to reduce Fraud , Waste and Abuse of Medicaid services...to reduce Fraud , Waste and Abuse of Medicaid services within Kentucky. Provides direction and guidance to… more
- 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 ... investigation experience involving economic or insurance related matters. + A clinical investigator must have in addition to the above requirements: A duly licensed… more
- General Dynamics Information Technology (Fairfax, VA)
- …**Experience:** 3 + years of related experience **Job Description:** **Marketplace Investigator ** **The Affordable Care Act (ACA) requires every state to establish ... of Program Integrity (CPI), the Centers for Medicare & Medicaid Services (CMS) has strong oversight and internal controls...CMS; and recommend referrals to law enforcement if potential fraud and abuse is identified.** **HOW YOU WILL MAKE… more
- 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
- Elevance Health (Atlanta, GA)
- …the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent ... Medicaid claims. **How You Will Make an Impact:** +...Reside in Missouri + Healthcare experience strongly preferred + Fraud certification from CFE, AHFI, AAPC or coding certificates… more
- 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 (Tampa, FL)
- …30% Serve as lead investigator on cases involving suspected Cost Report Fraud and Prospective Payment System Medicaid provider fraud involving: 1) ... Analyst position is in the Office of the Attorney General within the Medicaid Fraud Control Unit in Tampa, Florida or Orlando Florida, and involves auditing… more
- GE HealthCare (Boston, MA)
- …teams on legal issues related to GE HealthCare sponsored and investigator -initiated research and collaboration proposals and engagements. **Job Description** **Key ... leaders on legal and compliance issues surrounding company-sponsored and investigator -initiated research and collaboration proposals and engagements * Structure,… more
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