• Investigator - Medicaid Fraud

    State of Georgia (Fulton County, GA)
    …of our Medicaid Fraud Division. Duties & Responsibilities: Investigators conduct health care fraud investigations. Assists criminal justice personnel, ... not limited to, Analysts, Auditors, and Prosecutors in conducting on-site health care fraud and patient abuse investigations. Develops necessary knowledge… more
    State of Georgia (07/30/25)
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  • Medicaid Fraud Investigator (Special Agent…

    State of Colorado (Denver, CO)
    … Examiner; + Experience/training as a FTO or as a LE instructor; + Participation with health care fraud or elder abuse task forces or committees; + ... Medicaid Fraud Investigator (Special Agent III) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5057010) Apply...protect the state and federal funds dedicated to providing health care and medical services to Colorado… more
    State of Colorado (08/27/25)
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  • Senior Fraud Investigations Analyst…

    BlueCross BlueShield of North Carolina (NC)
    …The Special Investigations Unit (SIU) Investigator is responsible to conduct timely and thorough health care fraud investigations on behalf of the Company. ... to case closure + Prepares and conducts presentations and/or provides content for health care fraud and abuse education and awareness **What You'll Bring** +… more
    BlueCross BlueShield of North Carolina (07/25/25)
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  • Special Investigation Unit Lead Review Analyst…

    CVS Health (Harrisburg, PA)
    …of fraud and abuse **Required Qualifications** 1 year experience working on health care fraud , waste, and abuse investigatory and audits required. ... arbitrations, depositions, etc. **Preferred Qualifications** 1-3 years experience working on health care fraud , waste, and abuse investigations and audits… more
    CVS Health (08/20/25)
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  • Director Financial Investigations & Provider…

    Highmark Health (Pittsburgh, PA)
    …of legal and investigative procedures used in the detection and successful resolution of health care fraud , waste and abuse (FWA) cases **Language (Other ... strategic plan focuses on the detection and investigation of fraud , waste and abuse (FWA) and recoupment of related...with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as… more
    Highmark Health (08/08/25)
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  • Special Investigation Unit Analyst

    Corewell Health (Grand Rapids, MI)
    …investigation of fraud and abuse within Priority Health . Utilizes knowledge/expertise of health care fraud to investigate all types of health ... group, agent or other fraudulent entity. + 2 years of relevant experience Related health care experience One of the following certifications is required: +… more
    Corewell Health (08/08/25)
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  • Managed Care Organization (MCO) Program…

    State of Minnesota (St. Paul, MN)
    health benefits administration setting. Experience must demonstrate: + Direct involvement in health care fraud , waste, and abuse (FWA) investigations, ... Investigations Units (SIUs) to prevent, detect, and respond to fraud , waste, abuse, and noncompliance that may result in...Managed Care plans. + Understanding of Minnesota Health Care Programs (MHCP), especially Medical Assistance… more
    State of Minnesota (08/29/25)
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  • Investigator, Special Investigative Unit-Must…

    Molina Healthcare (Lexington, KY)
    …prevention, detection, investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste, and abuse. Duties include ... Services, Claims) to gather documentation pertinent to investigations. + Detects potential health care fraud , waste, and abuse through the identification of… more
    Molina Healthcare (08/28/25)
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  • Assistant United States Attorney

    Executive Office for US Attorneys and the Office of the US… (Atlanta, GA)
    …securities fraud , computer intrusion and hacking, government program fraud , identity theft, health care fraud , bank fraud , immigration fraud , ... seeks recovery of government funds fraudulently obtained, litigates affirmative civil fraud and enforcement actions, and defends the US Government's interest in… more
    Executive Office for US Attorneys and the Office of the US Attorneys (08/22/25)
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  • Health Insurance Fraud Analyst II

    MyFlorida (Tallahassee, FL)
    …to the prevention, detection, or investigation of fraud , waste or abuse in health care or experience in auditing, data analysis, or fraud detection. ... HEALTH INSURANCE FRAUD ANALYST II -... HEALTH INSURANCE FRAUD ANALYST II - 72004150 Date: Aug 19,...and other sources by applying your knowledge of heath care coding conventions, fraud schemes, general areas… more
    MyFlorida (08/20/25)
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