• Director, Compliance on Special…

    LA Care Health Plan (Los Angeles, CA)
    …Field Experience Required: At least 7 years of experience in healthcare compliance, fraud investigations , law enforcement, or related field. At least 5years of ... Director, Compliance on Special Investigations Unit and Fraud , Waste and...(DHCS), and state/federal requirements. Ensure effective case intake, triage, investigation , tracking, and resolution processes, including referral to law… more
    LA Care Health Plan (11/06/25)
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  • Fraud Investigation Analyst

    Zelis (Boston, MA)
    …and the personal interests that shape who you are. Position Overview The Fraud Investigation Analyst, Enterprise Fraud , will contribute significantly to ... fraudulent activities by conducting comprehensive reviews of all internal and external fraud monitoring alerts, performing fraud investigations , and… more
    Zelis (10/23/25)
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  • Senior Fraud Investigations Analyst…

    BlueCross BlueShield of North Carolina (NC)
    …$62,100.00 - $111,800.00 **Skills** Depositions, Evidence Collection, Forensic Accounting, Fraud Investigations , Investigation Techniques, Investigative ... is responsible to conduct timely and thorough health care fraud investigations on behalf of the Company....gaps on the business/organization. + In the course of investigation , may be required to provide deposition and/or testimony… more
    BlueCross BlueShield of North Carolina (10/14/25)
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  • Senior Fraud and Waste Investigator,…

    Humana (Tallahassee, FL)
    …& Abuse Investigations required + At least 2 years of healthcare fraud investigations and auditing experience + Knowledge of healthcare payment methodologies ... community and help us put health first** The Senior Fraud and Waste Professional conducts investigations of...requires an in-depth evaluation of variable factors. The Senior Fraud and Waste Professional coordinates investigation with… more
    Humana (11/13/25)
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  • Work From Home - Senior Complaints Coordinator…

    Capital One (St. Cloud, MN)
    Work From Home - Senior Complaints Coordinator - FDO Escalations - Fraud Account Management Investigations Solutions (FAMISE) **Are you looking for a challenging ... experience using Google Suite or Microsoft Office + At least 1 year of Fraud or Disputes experience **Preferred Qualifications** + At least 4 years of Customer… more
    Capital One (11/12/25)
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  • Manager, Fraud & Waste Investigation

    Humana (Denver, CO)
    …our caring community and help us put health first** The Manager, Fraud and Waste Investigator: Nurse Audit/Review performs clinical audit/validation processes to ... objectives and determines approach, resources, schedules and goals. The Manager, Fraud and Waste Investigator: Nurse Audit/Review validates and interprets medical… more
    Humana (11/04/25)
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  • Criminal Investigator - Medicaid Fraud

    State of Georgia (Fulton County, GA)
    …documentation for investigation and prosecutorial purposes in health care fraud and patient abuse investigations . Utilizes computers and the appropriate ... Division. Duties & Responsibilities: Investigators conduct health care fraud investigations . Assists criminal justice personnel, including,...active and in good standing. . Twelve months of fraud investigation or related experience. . Law… more
    State of Georgia (10/10/25)
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  • GFC Investigator (Brokerage - AML/ Fraud )

    Bank of America (Pennington, NJ)
    …Investment Management. In the investigative role, the Investigator conducts complex investigations , including fraud committed by external parties, securities ... GFC Investigator (Brokerage - AML/ Fraud ) Phoenix, Arizona;Pennington, New Jersey; Plano, Texas; Dallas,...The Global Financial Crimes Compliance (GFCC) Investigator performs end-to-end investigations across one or more lines of business relevant… more
    Bank of America (10/02/25)
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  • Fraud Investigator

    CIBC (Chicago, IL)
    …(https://www.cibc.com/en/about-cibc.html) Responsibilities The Fraud Analyst will report to the Fraud Investigations Manager of US Region Fraud ... St, 8th Fl **Employment Type** Regular **Weekly Hours** 40 **Skills** Financial Crime Investigations , Fraud Investigations , Fraud Monitoring, Time… more
    CIBC (11/04/25)
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  • Director of Investigations

    Columbia Bank (Phoenix, AZ)
    …Director who can design, implement, and maintain a best-in-class AML and Fraud Investigations program, including robust transaction monitoring systems, to ... Provide oversight and support services for groups that impact FID related to fraud investigations and AML transaction monitoring, process and policies. + Working… more
    Columbia Bank (11/13/25)
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