• Manager , Fraud & Waste…

    Humana (Boston, MA)
    …a part of our caring community and help us put health first** The Manager , Fraud and Waste Investigator: Nurse Audit/Review performs clinical ... of objectives and determines approach, resources, schedules and goals. The Manager , Fraud and Waste Investigator: Nurse Audit/Review validates and interprets… more
    Humana (11/04/25)
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  • Sr. Fraud Data Analyst

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …prepayment team. This position reports directly to the Data Science Fraud Manager and assists in the development of investigation targets, proposes new ... methods of data analytics and healthcare informatics to discover Fraud , Waste and Abuse activities as well...and fraud scores. + Independently generate potential fraud leads for investigation or referral to… more
    Blue Cross Blue Shield of Massachusetts (10/14/25)
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  • Manager , Special Investigation

    CVS Health (Boston, MA)
    …in federal and state audits. **Required Qualifications** + 2 to 5 years of managing healthcare fraud , waste and abuse investigations and audits. + 3 to 5 ... Brief Overview** Oversees corporate activities related to the prevention, investigation , and prosecution of health care fraud ...Leads a team in the planning and execution of investigations of acts of healthcare fraud and… more
    CVS Health (10/19/25)
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  • Investigator 1 - FWA Prepayment Review

    Point32Health (Canton, MA)
    …for conducting high-volume Pre-Payment Fraud Waste & Abuse ("FWA") investigations under the direction of the Manager , FWA Prepayment Review. The ... Investigation Unit ("SIU") responsible for leading complex provider investigations related to fraud , waste ,...every day! + Other duties as assigned by the Manager , Pre-Payment Review Qualifications - what you need to… more
    Point32Health (10/31/25)
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