- Humana (Oklahoma City, OK)
- …help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the Oklahoma Medicaid Team. This ... 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
- 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… more
- Humana (Santa Fe, NM)
- …and help us put health first** Humana is looking for an experienced Healthcare Investigator to join its industry leading Special Investigations Unit. Do you ... data requires an in-depth evaluation of variable factors. The Fraud and Waste Investigator collaborates in investigations...Teams o Business areas for all product lines (Medicare, Medicaid , Commercial) o Industry Trend areas **Use your skills… more
- AmeriHealth Caritas (Columbia, SC)
- …(ACFC). **Major Accountabilities:** + Ensures compliance with all requirements related to Special Investigation Units and fraud , waste and abuse investigations. ... administrative services. Discover more about us at www.amerihealthcaritas.com. The Investigator is responsible for conducting comprehensive investigations of reported,… 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
- 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
- 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
- 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...all regulatory, CMS, and WellCare Corporate guidelines in which special care is required to protect and enhance WellCare's… 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
- 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...DRUG FREE WORKPLACE: All OAG positions are "sensitive or special trust" and require favorable results on a background… more
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