• Senior Investigator , Special…

    CVS Health (Albany, NY)
    …in the United States. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit ... you will manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + Conduct high level,… more
    CVS Health (11/19/25)
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  • Investigator , Coding Special Investigative…

    Molina Healthcare (NY)
    …Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position uses ... of experience working in a FWA / SIU or Fraud investigations + Thorough knowledge of PC based software...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
    Molina Healthcare (11/20/25)
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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 (09/17/25)
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  • Lead Investigator , Special Investigative…

    Molina Healthcare (Rochester, NY)
    …insurance company + Minimum of two (2) years' experience working on healthcare fraud related investigations/reviews + Proven investigatory skill; ability to ... Certification, Association + Valid driver's license required. **Preferred Experience** + Healthcare Anti- Fraud Associate (HCAFA), Accredited Health Care Fraud more
    Molina Healthcare (11/21/25)
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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 ... investigation experience involving economic or insurance related matters. + A clinical investigator must have in addition to the above requirements: A duly licensed… more
    MVP Health Care (12/02/25)
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