• Senior Fraud and Waste Investigator

    Humana (Dayton, OH)
    …**Required Qualifications** + Must reside in Ohio + At least 2 years of healthcare fraud investigations and auditing experience + Knowledge of healthcare ... community and help us put health first** This Senior Fraud and Waste Investigator will serve as...Clinical Certifications, CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and investigative process development +… more
    Humana (11/20/25)
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  • Investigator , Special Investigative…

    Molina Healthcare (Bowling Green, KY)
    …ASSOCIATION** : + Health Care Anti- Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all ... **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation,… more
    Molina Healthcare (11/26/25)
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  • Law Enforcement Investigator II

    MyFlorida (Tampa, FL)
    …or education requirements of s. 943.135. Preference will be given to candidates with healthcare fraud investigative experience working in a Medicaid Fraud ... LAW ENFORCEMENT INVESTIGATOR II - 41001246 Date: Nov 21, 2025...experience, or five (5) years of work experience conducting healthcare fraud investigations. Note: All newly hired… more
    MyFlorida (11/22/25)
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  • Investigator , Coding Special Investigative…

    Molina Healthcare (Ann Arbor, MI)
    …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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  • CDOC - Criminal Investigator IV (Statewide)

    State of Colorado (CO)
    CDOC - Criminal Investigator IV (Statewide) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5144627) Apply  CDOC - Criminal Investigator IV ... + Independently investigate crimes in a prison facility; + As lead investigator / team leader, direct field investigations on a continuing basis, inclusive of… more
    State of Colorado (11/18/25)
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  • Criminal Investigator or Investigative…

    Idaho Division of Human Resources (Boise, ID)
    …at least 5 years of investigative experience, preferably in law enforcement, healthcare fraud or financial crimes. Strong analytical; interviewing, and ... minimum of 5 years of investigative experience, preferably in Medicaid or healthcare fraud , financial crimes or white-collar investigations. + Experience… more
    Idaho Division of Human Resources (10/23/25)
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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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  • Investigator /Special Agent 1-4

    Louisiana Department of State Civil Service (LA)
    …approach to uncover abuse and neglect of residents and complex financial fraud committed by healthcare providers, including hospitals, nursing homes, pharmacies, ... Investigator /Special Agent 1-4 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/5143725) Apply  ...in cybercrimes, white collar crimes, and public corruption. Medicaid Fraud Control Unit: The Louisiana Medicaid Fraud more
    Louisiana Department of State Civil Service (11/18/25)
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  • Special Investigator

    AmeriHealth Caritas (Columbus, OH)
    …An associate's degree, with a minimum of four years of experience working in healthcare fraud , waste, and abuse investigations and audits. + Experience and ... + Bachelor's degree with a minimum of two years of experience in the healthcare field working in fraud , waste, and abuse investigations and audits OR… more
    AmeriHealth Caritas (10/22/25)
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  • Lead Investigator , Special Investigative…

    Molina Healthcare (Cincinnati, OH)
    …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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