• Manager , Fraud and Waste, Special…

    Humana (Frankfort, KY)
    **Become a part of our caring community and help us put health first** The Manager , Fraud and Waste conducts investigations of allegations of fraudulent and ... abusive practices. The Manager , Fraud and Waste works within specific...Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of… more
    Humana (01/08/26)
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  • Senior Professional Liability Claims…

    Zurich NA (Frankfort, KY)
    …and internal controls throughout the claims process. + Identify and refer claims with subrogation or fraud potential to the appropriate internal teams for ... organizations. **This role will be filled at either the** **Senior or AVP Claims Professional** **Level.** **The hiring manager will determine the appropriate… more
    Zurich NA (01/16/26)
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  • Senior Manager , Global Product Quality…

    Otsuka America Pharmaceutical Inc. (Frankfort, KY)
    The Senior Manager , Global Product Quality - Biologics is responsible for managing quality oversight of clinical and commercial products at CMOs under contract by ... for use in clinical studies and commercial supply. + Reviews/approves deviations, investigations , CAPA plans and change controls per Otsuka Policies and Procedures.… more
    Otsuka America Pharmaceutical Inc. (12/03/25)
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  • Lead SIU Investigator

    Centene Corporation (Frankfort, KY)
    …may substitute for the Bachelors Degree . 5+ years of management experience Investigations and healthcare fraud -related investigations with audit and risk ... a subject matter expert for the Contractor's Program Integrity unit to reduce Fraud , Waste and Abuse of Medicaid services within Kentucky. Provides direction and… more
    Centene Corporation (01/06/26)
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  • Lead Investigator, Special Investigative…

    Molina Healthcare (KY)
    …from opinions + Knowledge of investigative and law enforcement procedures with emphasis on fraud investigations + Knowledge of Managed Care and the Medicaid and ... company + Minimum of three (3) years' experience working on healthcare fraud related investigations /reviews + Proven investigatory skill; ability to organize,… more
    Molina Healthcare (11/21/25)
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  • FEMA Disaster Management Accountant

    CDM Smith (Covington, KY)
    …CDM Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical in evaluating and analyzing financial ... data related to disaster-related claims , including property damage, business interruption, and other loss...other loss categories. The specialist will conduct thorough forensic investigations to identify discrepancies, detect potential fraud ,… more
    CDM Smith (12/11/25)
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  • Pharmacy Investigator Senior

    Elevance Health (Louisville, KY)
    …AHFI, CPC, Paralegal, RN, JD or Law Enforcement preferred. + Pharmacy claims , records and investigations , experience strongly preferred. + Pharmacy technician ... and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client funds...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
    Elevance Health (01/09/26)
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