• SIU Program Integrity Investigator - Remote…

    Magellan Health Services (Boise, ID)
    …and Certifications - Required License and Certifications - Preferred AHFI - Accredited Healthcare Fraud Investigator - EnterpriseEnterprise, CFE - Certified ... from internal and external sources + Use knowledge of healthcare coding conventions, fraud schemes, and general...Power Point. General Job Information Title SIU Program Integrity Investigator - Remote (In Idaho) Grade 24 Work Experience… more
    Magellan Health Services (12/27/25)
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  • Associate Investigator

    Highmark Health (Pittsburgh, PA)
    …+ Certified Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge ... :** **JOB SUMMARY** The job is responsible for developing and maintaining an anti- fraud program which includes development and delivery of training and filing of … more
    Highmark Health (12/18/25)
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  • Senior Investigator (Dental, Aetna SIU)

    CVS Health (MI)
    …each and every day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Dental/Pharmacy/Broker Investigative ... role, you will manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). This position will be focused on Dental… more
    CVS Health (01/17/26)
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  • AVP, Special Investigations Unit

    BlueCross BlueShield of North Carolina (NC)
    …**:** + Relevant certifications (eg, Certified Fraud Examiner (CFE), accredited healthcare fraud investigator (AHFI) **What You'll Get** : + ... Stay informed about changes in laws, regulations, and industry practices related to healthcare fraud . + Assist in preparing documentation for audits, compliance… more
    BlueCross BlueShield of North Carolina (01/07/26)
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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 ... and 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… more
    Humana (01/10/26)
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  • Fraud and Waste Investigator

    Humana (Little Rock, AR)
    …a part of our caring community and help us put health first** The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive ... practices. The Fraud and Waste Professional 2 work assignments are varied...years of investigative and/or claims experience + Knowledge of healthcare payment methodologies + Strong organizational, interpersonal, and communication… more
    Humana (01/16/26)
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  • External Fraud Investigator

    US Bank (Columbus, OH)
    …security and give you peace of mind. Our benefits include the following: + Healthcare (medical, dental, vision) + Basic term and optional term life insurance + ... Short-term and long-term disability + Pregnancy disability and parental leave + 401(k) and employer-funded retirement plan + Paid vacation (from two to five weeks depending on salary grade and tenure) + Up to 11 paid holiday opportunities + Adoption assistance… more
    US Bank (01/17/26)
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  • Law Enforcement Investigator II - 1

    MyFlorida (Orlando, 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 - 41000797 1 Date: Jan 15,...experience, or five (5) years of work experience conducting healthcare fraud investigations. Note: All newly hired… more
    MyFlorida (01/16/26)
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  • Lead Investigator , Special Investigative…

    Molina Healthcare (KY)
    …insurance company + Minimum of three (3) 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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  • CDOC - Criminal Investigator IV (Statewide)

    State of Colorado (CO)
    CDOC - Criminal Investigator IV (Statewide) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5188689) 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 (01/07/26)
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