• Investigator, Special Investigative Unit (Remote)-…

    Molina Healthcare (Milwaukee, WI)
    …reporting, and when appropriate, recovery of money related to health care fraud , waste, and abuse. Duties include performing accurate and reliable medical review ... Counsel, and Medical Officers in order to achieve and maintain appropriate anti- fraud oversight. **Job Duties** + Responsible for developing leads presented to the… more
    Molina Healthcare (08/15/25)
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  • Fraud Waste and Abuse Division Director

    State of Colorado (Denver, CO)
    …A combination of related education and/or relevant experience in an occupation related to healthcare fraud , waste, and abuse (FWA) operations that is equal to ... Fraud Waste and Abuse Division Director Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5033338) Apply  Fraud Waste and Abuse Division… more
    State of Colorado (08/08/25)
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  • Senior Fraud & Waste Investigator

    Humana (Oklahoma City, OK)
    …**Required Qualifications** + **Must be an Oklahoma resident** + 2+ years of healthcare fraud investigations and auditing experience + Knowledge of healthcare ... help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the Oklahoma Medicaid Team. This team of… more
    Humana (08/08/25)
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  • Assistant Attorney General- Medicaid Fraud

    State of Georgia (Fulton County, GA)
    …or more items below: + Attorneys with civil litigation experience, with an emphasis on healthcare or fraud matters. + Demonstrated ability to work in a team is ... Assistant Attorney General- Medicaid Fraud Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/67792/other-jobs-matching/location-only) Hot… more
    State of Georgia (08/02/25)
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  • Fraud and Waste Investigator

    Humana (Oklahoma City, OK)
    …Oklahoma resident** + Strong clinical experience to include multiple practice areas + Healthcare fraud investigations and auditing experience + Knowledge of ... us put health first** Humana Healthy Horizons in Oklahoma is seeking a Fraud and Waste Professional 2 who conducts investigations of allegations of fraudulent and… more
    Humana (08/08/25)
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  • Fraud Manager, PINS

    Zelis (St. Petersburg, FL)
    …prevention, investigations, or risk management - preferably in payments, fintech, or healthcare . + Proven expertise in fraud detection tools, behavioral ... So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more… more
    Zelis (07/31/25)
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  • Manager, Special Investigation

    CVS Health (Charleston, WV)
    …investigators and analysts to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to ... a team in the planning and execution of investigations of acts of healthcare fraud and abuse by both members and providers. Provides direction and counsel on… more
    CVS Health (08/01/25)
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  • Analyst, Investigator (Aetna SIU)

    CVS Health (Annapolis, MD)
    …- Conducts investigations to effectively pursue the prevention, investigation, and prosecution of healthcare fraud and abuse, to recover lost funds, and to ... and practices. - Conducts investigations of known or suspected acts of healthcare fraud and abuse. - Communicates with federal, state, and local law enforcement… more
    CVS Health (07/26/25)
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  • Special Investigation Unit Lead Review Analyst…

    CVS Health (Columbus, OH)
    …conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to ... and local law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters. - Demonstrates high level of knowledge and… more
    CVS Health (08/14/25)
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  • Investigator

    Highmark Health (Atlanta, GA)
    …3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations **Preferred** + 1 year in Financial Analysis ... Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider… more
    Highmark Health (08/15/25)
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