Principal Investigator (Gastroenterology) Professional Case ManagementPrincipal Investigator (Gastroenterology)Riverdale, GA$156,600–$266,700Risks to research subjects are minimized by using procedures which are consistent with sound research design and which do not unnecessarily expose the subjects to risk; and, whenever appropriate, by using procedures already being performed on the subjects for diagnostic or treatment purposes; Risks to human research subjects are reasonable in relation to the anticipated benefits (if any) to the individual, and the importance of the knowledge that may be expected to result; Selection of human subjects and patients for research participation is equitable; Individuals are adequately informed of the risks and benefits of research participation and the procedures that will be involved in the research, and that informed consent will be obtained from each prospective human research subject, or his/her legally authorized representative, in accordance with, and to the extent required, by company policies and federal regulations; Informed consent of human research subjects will be obtained in advance of research participation and appropriately documented in accordance with, and to the extent required, by company policies and federal regulations; Where appropriate, there is routine monitoring of the data collected to ensure the safety of human research subjects; The privacy of human research subjects is protected and the confidentiality of data is maintained; Appropriate additional safeguards are included in the study to protect the rights and welfare of human research subjects who are likely to be vulnerable to coercion or undue influence (e.g., children, prisoners, individuals with impaired decision-making capacity, or economically or educationally disadvantaged persons). Maintaining adequate, current, and accurate records of research data, outcomes, and reportable new information to permit an ongoing assessment of the risk/benefit ratio of study participation; Reporting promptly any internal or external adverse event that is considered to be unexpected, serious, and possibly or definitely related to the study; Reporting promptly any significant changes in the risk/benefit of study participation; Ensuring that, in the event a research subject experiences a significant adverse event, every reasonable effort is made to provide the subject with adequate care to correct or alleviate the consequences of the adverse event to the extent possible; Ensuring that human research subjects are kept fully informed of any new information that may affect their willingness to continue to participate in the research study; Ensuring that all listed investigators have the appropriate credentials to conduct the portion of the study in which they are involved and have completed the applicable company required training modules; Ensuring that conduct of the research study adheres to Good Clinical Practice guidelines.
Principal Investigator (Psychiatry) Professional Case ManagementPrincipal Investigator (Psychiatry)Dallas, TX$156,600–$266,700Risks to research subjects are minimized by using procedures which are consistent with sound research design and which do not unnecessarily expose the subjects to risk; and, whenever appropriate, by using procedures already being performed on the subjects for diagnostic or treatment purposes; Risks to human research subjects are reasonable in relation to the anticipated benefits (if any) to the individual, and the importance of the knowledge that may be expected to result; Selection of human subjects and patients for research participation is equitable; Individuals are adequately informed of the risks and benefits of research participation and the procedures that will be involved in the research, and that informed consent will be obtained from each prospective human research subject, or his/her legally authorized representative, in accordance with, and to the extent required, by company policies and federal regulations; Informed consent of human research subjects will be obtained in advance of research participation and appropriately documented in accordance with, and to the extent required, by company policies and federal regulations; Where appropriate, there is routine monitoring of the data collected to ensure the safety of human research subjects; The privacy of human research subjects is protected and the confidentiality of data is maintained; Appropriate additional safeguards are included in the study to protect the rights and welfare of human research subjects who are likely to be vulnerable to coercion or undue influence (e.g., children, prisoners, individuals with impaired decision-making capacity, or economically or educationally disadvantaged persons). Maintaining adequate, current, and accurate records of research data, outcomes, and reportable new information to permit an ongoing assessment of the risk/benefit ratio of study participation; Reporting promptly any internal or external adverse event that is considered to be unexpected, serious, and possibly or definitely related to the study; Reporting promptly any significant changes in the risk/benefit of study participation; Ensuring that, in the event a research subject experiences a significant adverse event, every reasonable effort is made to provide the subject with adequate care to correct or alleviate the consequences of the adverse event to the extent possible; Ensuring that human research subjects are kept fully informed of any new information that may affect their willingness to continue to participate in the research study; Ensuring that all listed investigators have the appropriate credentials to conduct the portion of the study in which they are involved and have completed the applicable company required training modules; Ensuring that conduct of the research study adheres to Good Clinical Practice guidelines.
Principal Investigator (Neurology) Professional Case ManagementPrincipal Investigator (Neurology)Dallas, TX$156,600–$266,700Risks to research subjects are minimized by using procedures which are consistent with sound research design and which do not unnecessarily expose the subjects to risk; and, whenever appropriate, by using procedures already being performed on the subjects for diagnostic or treatment purposes; Risks to human research subjects are reasonable in relation to the anticipated benefits (if any) to the individual, and the importance of the knowledge that may be expected to result; Selection of human subjects and patients for research participation is equitable; Individuals are adequately informed of the risks and benefits of research participation and the procedures that will be involved in the research, and that informed consent will be obtained from each prospective human research subject, or his/her legally authorized representative, in accordance with, and to the extent required, by company policies and federal regulations; Informed consent of human research subjects will be obtained in advance of research participation and appropriately documented in accordance with, and to the extent required, by company policies and federal regulations; Where appropriate, there is routine monitoring of the data collected to ensure the safety of human research subjects; The privacy of human research subjects is protected and the confidentiality of data is maintained; Appropriate additional safeguards are included in the study to protect the rights and welfare of human research subjects who are likely to be vulnerable to coercion or undue influence (e.g., children, prisoners, individuals with impaired decision-making capacity, or economically or educationally disadvantaged persons). Maintaining adequate, current, and accurate records of research data, outcomes, and reportable new information to permit an ongoing assessment of the risk/benefit ratio of study participation; Reporting promptly any internal or external adverse event that is considered to be unexpected, serious, and possibly or definitely related to the study; Reporting promptly any significant changes in the risk/benefit of study participation; Ensuring that, in the event a research subject experiences a significant adverse event, every reasonable effort is made to provide the subject with adequate care to correct or alleviate the consequences of the adverse event to the extent possible; Ensuring that human research subjects are kept fully informed of any new information that may affect their willingness to continue to participate in the research study; Ensuring that all listed investigators have the appropriate credentials to conduct the portion of the study in which they are involved and have completed the applicable company required training modules; Ensuring that conduct of the research study adheres to Good Clinical Practice guidelines.
Sr. Corporate Investigator, Enterprise Protection Program - Global Investigations (EPP-GI) Amazon.com IncSr. Corporate Investigator, Enterprise Protection Program - Global Investigations (EPP-GI)Arlington, VAThe Senior Corporate Investigator drives team(s) and partners to meet program and product goals, manages cross-functional projects, and may manage global projects related to data center investigations and/or corporate security initiatives as necessary. Develop and deliver presentations and communicate effectively with leaders up to three tiers above level and cross-functional audiences across Security, Legal, HR/ER, Facilities Department, and external partners on investigative findings, trends, and program updates.
Financial Fraud Investigator - Corporate Security - Vice-President Morgan StanleyFinancial Fraud Investigator - Corporate Security - Vice-PresidentPurchase, NYWhat you'll do in the role: Ensure appropriate actions are taken to mitigate potential losses to clients and Morgan Stanley (e.g., restricting accounts to prevent further fraudulent activity, coordinating the reissue of credit/debit cards, closing accounts, advising account officers and their clients, and investigating cryptocurrency fraud). We are seeking a Corporate Security, Financial Fraud Investigator to conduct time-sensitive, professional, and comprehensive investigations into allegations and business-unit escalations involving wire transfers, debit/credit cards, checks, ACH, Cryptocurrency, and other suspected fraud that may adversely affect the financial integrity of Morgan Stanley and its clients.
Corporate Investigator, Enterprise Protection Program - Global Investigations Amazon.com IncCorporate Investigator, Enterprise Protection Program - Global InvestigationsSeattle, WAThe Enterprise Protection Program - Global Investigations (EPP-GI) team is a specialized unit within Corporate Security & Investigations dedicated to safeguarding personnel, information, and assets across the global enterprise. You"ll balance independent investigative work with team coordination, sharing insights, supporting peers on complex cases, and contributing to trend analysis that helps prevent future incidents.
Corporate Ethics & Compliance Investigator Centene Management CompanyCorporate Ethics & Compliance InvestigatorThoroughly documents, organizes, and reviews case files, electronic and hardcopy, relative to each investigation in accordance with Company policy and ensures remediation activities are tracked and implemented. This includes defining investigation strategy, preserving evidence, conducting interviews, analyzing records, conducting root cause analysis, and recommended corrective and disciplinary actions.
Corporate Investigator Goodwill of North GeorgiaCorporate InvestigatorDecatur, GAKey responsibilities include conducting investigations, performing audits, providing training to team members when necessary, and collaborating with other leaders to protect company assets, foster a positive workplace environment, and minimize financial losses. Develops and implements effective strategies to timely and successfully resolve internal and external investigations related to employee theft, policy violations, and all criminal activities occurring on Goodwill property.
Corporate Fraud Investigator Glacier BankCorporate Fraud InvestigatorHelena, MTThis role involves handling cases related to electronic banking fraud (including Zelle), new account abuse, deposit fraud, check forgery, elder abuse, debit and credit card fraud, suspected money laundering, check kiting, identity theft, internal fraud, loan fraud, and other complex schemes. WA Applicants ONLY range:Spokane $32.65 to $48.97 an hourWenatchee $33.10 to $49.66 an hourDescription- Conduct routine investigations into suspected fraud including identity theft, account abuse, check fraud, elder abuse, debit/credit card fraud, loan fraud, electronic banking fraud (e.g., Zelle), internal fraud, loan fraud, and others.
NewSenior Corporate Investigator - Ethics & Compliance LumenSenior Corporate Investigator - Ethics & ComplianceSalem, ORThe successful candidate will demonstrate strong communication skills and sound judgment, managing complex situations with discretion. Lumen is seeking a Lead Corporate Investigator to lead internal investigations into employee conduct and business integrity.
NewSenior Corporate Investigator Ethics & Compliance (Remote) LumenSenior Corporate Investigator Ethics & Compliance (Remote)Austin, TXRemoteThis role requires a Juris Doctor degree and experience with investigations, managing sensitive matters discreetly and independently. Lumen is seeking a Lead Corporate Investigator to lead complex internal investigations into employee conduct and workplace issues.
NewLead Corporate Investigator - Ethics & Compliance LumenLead Corporate Investigator - Ethics & ComplianceNashville, TNLumen is seeking a Lead Corporate Investigator to manage and lead internal investigations related to employee conduct and business integrity. The successful candidate will work closely with HR and Legal, ensuring that all investigations maintain a high degree of professionalism and confidentiality.
AML Investigator - Corporate MGM ResortsAML Investigator - CorporateUs, NevadaThe AML Investigator is responsible for conducting due diligence reviews on casino customers to identify potential Anti-Money Laundering (AML) and Source of Funds (SOF) concerns that may present a legal, regulatory, or reputational risk to the Company. Under the direction of Compliance management, the AML Investigator is responsible for ensuring strict adherence to the Company's policies as well as federal/state regulatory requirements, with a focus on comprehensive AML/BSA investigations and Know-Your-Customer (KYC) reviews.
Fraud Investigator I United Community BankFraud Investigator IGreenville, South CarolinaRemote$38,769–$57,876 / yearFull timeOverview: The Fraud Investigator I plays a key role in protecting the bank and its customers from financial loss by investigating fraud claims and suspicious activity across deposit, payment, card, and digital banking channels. Working in a fast-paced environment, the Fraud Investigator I partners with customers and internal teams to resolve fraud cases, maintain regulatory compliance, and identify emerging fraud trends and recovery opportunities.
Healthcare Fraud Investigator/Case Developer SGI Global, LLCHealthcare Fraud Investigator/Case DeveloperMuskogee, OKThe Investigator/Case Developer will support the Criminal Division's Healthcare Fraud and Abuse Control Program by conducting investigations involving healthcare fraud, fraud and abuse affecting federal healthcare programs, opioid diversion, and other criminal fraud matters within the jurisdiction of the USAO. SGI Global is seeking a Healthcare Fraud Investigator/Case Developer to provide investigative support services to the United States Attorney's Office (USAO) for the Eastern District of Oklahoma (EDOK).
Regional Fraud Investigator Burke & Herbert BankRegional Fraud InvestigatorAlexandria, VA$27–$37 / hourInvestigate and manage external fraud investigations, such as check fraud, new account fraud, elder exploitation, wire fraud, online take over and other, ensuring cases are handled timely, and documented accurately with a concise case summary, following existing procedures. This position is responsible for conducting comprehensive external fraud investigations on check fraud, wire fraud, account take over, identity theft, new account fraud, elderly exploitation, and other types of fraud, to detect and prevent fraud losses to the bank and the customer.
Sr. Investigator (Full-time, Remote) Integrity Management Services, Inc.Sr. Investigator (Full-time, Remote)Alexandria, VARemoteIntegrity Management Services, Inc. (IntegrityM) is an award-winning, women-owned small business specializing in assisting government and commercial clients in compliance and program integrity efforts, including the prevention and detection of fraud, waste and abuse in government programs. In this role, the Senior Investigator will conduct investigations that support healthcare program integrity initiatives by identifying potential fraud, waste, and abuse (FWA), analyzing complex information, and developing investigative findings.
Clinical Special Investigations Unit Investigator- Health Plan Parkland HealthClinical Special Investigations Unit Investigator- Health PlanMust be currently certified and in good standing or obtain certification within twelve (12) months of hire with one of the following: Health Care Anti-Fraud Associate (HCAFA), Accredited Health Care Fraud Investigator (AHFI), Association of Certified Fraud Examiners (CFE), or National Health Care Anti-Fraud Association (NHCAA). Responds to Requests for Information (RFIs) from National Benefit Integrity MEDIC, U.S. Office of Personnel Management Office of the Inspector General (OPM OIG), State Departments of Insurance (DOI), and other law enforcement agencies, as appropriate.
NewRisk Investigator - Third Party/ATO Fraud Mercury Technologies IncRisk Investigator - Third Party/ATO Fraud$121,700–$152,100 / yearAs a member of our Account Fraud team, you''ll investigate escalated account takeover cases, assess account security, coordinate containment and recovery efforts, and communicate directly with customers through some of their most stressful moments. In this role, you''ll help protect our customers by investigating suspected account compromise, responding quickly to high-risk security incidents, and serving as the primary point of contact for customers during critical account recovery events.
Clinical Special Investigations Unit Investigator- Health Plan Parkland HospitalClinical Special Investigations Unit Investigator- Health PlanTXMust be currently certified and in good standing or obtain certification within twelve (12) months of hire with one of the following: Health Care Anti-Fraud Associate (HCAFA), Accredited Health Care Fraud Investigator (AHFI), Association of Certified Fraud Examiners (CFE), or National Health Care Anti-Fraud Association (NHCAA). Responds to Requests for Information (RFIs) from National Benefit Integrity MEDIC, U.S. Office of Personnel Management Office of the Inspector General (OPM OIG), State Departments of Insurance (DOI), and other law enforcement agencies, as appropriate.
Fraud Investigator I United Community Banks IncFraud Investigator IGreenville, SCRemote$38,769–$57,876 / yearWorking in a fast-paced environment, the Fraud Investigator I partners with customers and internal teams to resolve fraud cases, maintain regulatory compliance, and identify emerging fraud trends and recovery opportunities. The Fraud Investigator I plays a key role in protecting the bank and its customers from financial loss by investigating fraud claims and suspicious activity across deposit, payment, card, and digital banking channels.
Sr Fraud, Waste and Abuse Investigator (Investigator Sr) CalOptimaSr Fraud, Waste and Abuse Investigator (Investigator Sr)Orange, CA$72,096–$115,353 / yearWe are hoping you will join us as a Sr Fraud, Waste and Abuse Investigator (Investigator Sr) and help shape the future of healthcare where you'll be an integral part of our OOC - Fraud & Waste team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet.
SIU Investigator III (Health Plan experience required) CareSourceSIU Investigator III (Health Plan experience required)Indiana, IN$72,200–$115,500 / yearCareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. Job Summary: The Special Investigations Unit (SIU) III is responsible for investigating and resolving high complexity allegations of healthcare fraud, waste and abuse (FWA) by medical professional, facilities, and members.
Surveillance Investigator (Part-Time) VRC InvestigationsSurveillance Investigator (Part-Time)Omaha, NebraskaVRC provides their investigators with necessary equipment and comparable pay, to include drive time, above normal commute mileage reimbursement, company paid licensing fees in most states and allowance for non-reimbursed business expenses. We currently have career opportunities for experienced, self-determined, and highly motivated SURVEILLANCE INVESTIGATORS that would like to join our team of professionals in our efforts to deter and combat insurance fraud.
Surveillance Investigator VRC InvestigationsSurveillance InvestigatorNashville, TennesseeVRC provides their investigators with necessary equipment and comparable pay, to include drive time, above normal commute mileage reimbursement, company paid licensing fees in most states and allowance for non-reimbursed business expenses. We currently have career opportunities for experienced, self-determined, and highly motivated SURVEILLANCE INVESTIGATORS that would like to join our team of professionals in our efforts to deter and combat insurance fraud.
Part-Time Surveillance Investigator VRC InvestigationsPart-Time Surveillance InvestigatorColumbia, South CarolinaVRC provides their investigators with necessary equipment and comparable pay, to include drive time, above normal commute mileage reimbursement, company paid licensing fees in most states and allowance for non-reimbursed business expenses. We currently have career opportunities for experienced, self-determined, and highly motivated SURVEILLANCE INVESTIGATORS that would like to join our team of professionals in our efforts to deter and combat insurance fraud.
Consumer Transaction Monitoring Investigator Guidehouse IncConsumer Transaction Monitoring InvestigatorSan Antonio, TXEnd to end understanding of Transaction Monitoring/ KYC/ Screening/ Fraud Operations/Jurisdiction specific SAR filing/Narrative from documentary and non-documentary verification and as per relevant policy, nature of business, source of wealth/funds, and customer screening against the watchlist of Sanctions, PEP, and adverse media. Ability to conduct detailed investigations using vendors and open sources to remediate compliance alerts and to independently research, analyze, and recommend solutions to close open items and discrepancies.
Health Plan Special Investigative Unit Investigator - Health Alliance Plan Henry Ford HospitalHealth Plan Special Investigative Unit Investigator - Health Alliance PlanTroy, MICollaborative Skills: Demonstrates strong teamwork and collaboration abilities, effectively working with other investigators to achieve common goals and take responsibility for team outcomes while contributing to the overall success of the team. Proficiency using excel including ability to analyze large data sets to identify trends, anomalies, and opportunities for improvement, using data visualization techniques to present findings effectively.
Fraud Investigator Synovus Financial CorpFraud InvestigatorColumbia, SCPrepares and submits case narratives for Suspicious Activity Reports (SAR) to the AML/BSA department for review and FinCEN filing, ensuring narrative and SAR form are completed accurately and within procedural and regulatory deadlines while maintaining detailed records of narratives to provide supporting documentation for audits and regulatory reviews. Required Knowledge, Skills, & Abilities: Knowledge of applicable federal and state laws related to financial crimes including the Uniform Commercial Code (UCC), Regulation E, Regulation CC, and the Law Enforcement Criminal Code.
AGO Senior Investigator/Analyst | Medicaid Fraud & Abuse Division | Seattle State of WashingtonAGO Senior Investigator/Analyst | Medicaid Fraud & Abuse Division | SeattleSeattle, WA$6,870–$9,246The incumbent develops sources of information relating to Medicaid fraud and abuse and neglect in residential facilities; executes search warrants; collects, preserves and handles evidence in accordance with established rules of evidence; conducts surveillance; conducts criminal and civil interviews; prepares written reports, affidavits and other investigative documents; serves as a subject matter expert in civil and criminal healthcare fraud investigations. With the goal of employee health and wellness, we also offer: Flexible schedules and part-time/hybrid telework options; A Wellness Program, an Infants in the Workplace Program, and the Employee Assistance Program, which provides counseling, webinar, and other cost-free support resources; Numerous employee-driven affinity groups to foster community and connection, including Bereavement, Elder Care, Parenting, POC, LGBTQ+, Veterans and more.
Member Account Protection Investigator StratAcuity Staffing Partners IncMember Account Protection InvestigatorAnaheim, CA$43–$54 / hourIn terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts.
NewGlobal Investigator, Security Investigations and Assessments Google LLCGlobal Investigator, Security Investigations and AssessmentsBoulder, COAs part of the Global Security and Resilience Services (GSRS) organization, the Security Investigations and Assessments (SIA) team aims to protect Google"s people, property, and information through proactive risk mitigation, objective investigations and assessments, expert advisory service, and data-driven insights. We conduct thorough investigations into potential security violations and policy breaches, analyze threats to identify vulnerabilities, and collaborate with cross-functional partners to provide expert guidance on security best practices.
Forensic Accountant Investigator Montana GovernmentForensic Accountant InvestigatorHelena, MTThe functions within the office include defense of Montana's laws as passed by the Legislature, constitutional challenges, determining legal sufficiency of ballot initiatives, prosecution of criminals, handling all phases of litigation from district court proceedings through appeal, and complex litigation of antitrust matters. The incumbent analyze complex transactions to detect embezzlement, trace hidden assets, and provide expert testimony, often working with law enforcement or legal counsel to support litigation and investigations.
SIU Investigator Allied UniversalSIU InvestigatorGeneva, NY$27–$32 / hourAllied Universal SkillBridge Program Allied Universal partners with the U.S. Department of Defense (DoD) SkillBridge Program to support transitioning service members with up to 180 days of on-the-job training during their final months of active duty, while they continue to receive full DoD pay and benefits. Dog Detection Spotlight - Kyle and Maverick As part of Allied Universal Enhanced Protection Services' fleet of detection canine teams, Kyle and Maverick are trained and certified to screen cargo under the U.S. Transportation Security Administration's (TSA) Third-Party Canine (3PK9) Program.
Program Integrity Investigator IV CareSourceProgram Integrity Investigator IVOhio WFH, OH$83,000–$132,800 / yearReview reports and data for pattern identification, special cause variation identification, trend analysis, or other techniques that will reveal intelligence for identification of any associative or causal relationships pertaining to Fraud Waste and Abuse and Error, providing management level summaries that explain key findings and providing documentation for use during Audits. Utilizes a variety of data analytics platforms to mine large volumes of data to identify and mitigate fraudulent claim activity, discover patterns and anomalies in billing behavior and develop metrics around transactional and operational data to report on fraud attempts, losses and trends.
Transaction Monitoring Investigator Guidehouse IncTransaction Monitoring InvestigatorSan Antonio, TXEnd to end understanding of Transaction Monitoring/ KYC/ Screening/ Fraud Operations/Jurisdiction specific SAR filing/Narrative from documentary and non-documentary verification and as per relevant policy, nature of business, source of wealth/funds, and customer screening against the watchlist of Sanctions, PEP, and adverse media. Job Family: Investigator Travel Required: None Clearance Required: None What You Will Do: The responsibilities of the Analyst will include, but are not limited to: Performing AML alert/case reviews, seeking to mitigate risks associated to financial crimes and suspicious activity.
Desktop Investigator VRCDesktop InvestigatorDenton, TexasCompensation: *]:pointer-events-auto [content-visibility:auto] supports-[content-visibility:auto]:[contain-intrinsic-size:auto_100lvh] R6Vx5W_threadScrollVars scroll-mb-[calc(var(--scroll-root-safe-area-inset-bottom,0px)+var(--thread-response-height))] scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto"> Accepted candidates will be paid a competitive hourly rate of $18–$20 per hour, commensurate with relevant experience. The desktop investigator will complete tasks with other team members under management supervision, and when needed, will have the opportunity to cross train in other departments/divisions.
Investigator, Special Investigative Unit Molina Healthcare IncInvestigator, Special Investigative UnitFLCoordinates with various internal customers (e.g., provider services, contracting and credentialing, healthcare services, member services, claims, etc.), to gather documentation pertinent to investigations. Responsible for reviewing and analyzing information to draw conclusions on allegations of FWA and/or may determine appropriateness of care, and recognizing and adhering to national and local coding and billing guidelines in order to maintain coding accuracy and excellence.
Investigator, Special Investigative Unit-Nebraska Molina Healthcare IncInvestigator, Special Investigative Unit-NebraskaLincoln, NECoordinates with various internal customers (e.g., provider services, contracting and credentialing, healthcare services, member services, claims, etc.), to gather documentation pertinent to investigations. Responsible for reviewing and analyzing information to draw conclusions on allegations of FWA and/or may determine appropriateness of care, and recognizing and adhering to national and local coding and billing guidelines in order to maintain coding accuracy and excellence.
INVESTIGATOR State Of CaliforniaINVESTIGATORLos Angeles, CA$6,339–$10,609 / yearExamples of complex investigations include but are not limited to: criminal sexual exploitation of patients, cases involving drug violations, unlicensed practice of medicine, unlicensed corporate practice of medicine, insurance fraud, and allegations of practicing medicine while impaired (drug use, alcohol abuse, and mental disorders). Under the direction of the Supervising Investigator I, the Health Quality Investigation Unit (HQIU), the Division of Investigation (DOI), the incumbent works at the training, entry, and journey level conducting complex administrative, criminal, and civil investigations of physician and surgeons and certain allied healthcare professionals.
Senior Insider Risk Investigator Wintrust Financial CorpSenior Insider Risk InvestigatorRosemont, IL$150,000–$165,000 / yearWe serve clients in all 50 states with more than 200 branch banking locations in Illinois, southwestern Florida, northwestern Indiana, west Michigan and southern Wisconsin and commercial banking offices in Chicago, Denver, Milwaukee, Grand Rapids, Mich., and in key branch banking locations throughout Illinois. The Senior Insider Risk Investigator serves as the lead investigator for the Insider Risk Program, responsible for leading complex investigations involving data loss, insider threats, policy violations, misuse of company assets, and emerging AI-related risks.
Asset Protection Investigator SaksAsset Protection InvestigatorSan Francisco, FloridaBy leveraging the most comprehensive luxury customer data platform in North America, cutting-edge technology, and strong partnerships with the world's most esteemed brands, Saks Global is shaping the future of luxury retail. Saks Global is the largest multi-brand luxury retailer in the world, comprising Saks Fifth Avenue, Neiman Marcus, Bergdorf Goodman, and Saks OFF 5TH.
Asset Protection Investigator Saks Global Enterprises LLCAsset Protection InvestigatorBoca Raton, FL$21.53–$26.91 / hourBy leveraging the most comprehensive luxury customer data platform in North America, cutting-edge technology, and strong partnerships with the world's most esteemed brands, Saks Global is shaping the future of luxury retail. Saks Global is the largest multi-brand luxury retailer in the world, comprising Saks Fifth Avenue, Neiman Marcus, Bergdorf Goodman, and Saks OFF 5TH.
Asset Protection Intelligence Investigator The Home Depot IncAsset Protection Intelligence InvestigatorAtlanta, GASuccess requires strong data and technology capability-comfort working with large amounts of information from sources like sales activity, online orders, other research tools, and store video-then using analytics tools (such as Google BigQuery, dashboards, and spreadsheets) to spot patterns, confirm linkages, and quantify trends. Key skills include clear communication and organized documentation, paired with the ability to use investigative technologies to produce practical work products-lead summaries, investigative packages, and trend updates-that are easy to understand and easy to hand off to the right owners.
Intelligence Analyst / Investigator Boost Media GroupIntelligence Analyst / InvestigatorFolsom, CAisMobile":false,"iframe":"true","jobType":"Full time","applyName":"Apply Now","zsoid":"29398526","isRemoteJob":true,"FontFamily":"PuviRegular","jobOtherDetails":[{"fieldLabel":"Industry","uitype":2,"value":"Communications"},{"fieldLabel":"Work Experience","uitype":2,"value":"2-3years"},{"fieldLabel":"Salary","uitype":1,"value":"$10-$12"}],"headerName":"Intelligence Analyst \/ Investigator","widgetId":"231541000000061217","isJobBoard":"false","userId":"231541000000040483","attachArr":[],"customTemplate":"3","isCandidateLoginEnabled":true,"jobId":"231541000057940002","FontSize":"15","location":"","embedsource":"CareerSite","logoId":"3sl5s6a8b71b4b79c4aa49dbdd948a2c53e8c"}. Experience in insurance investigations, SIU, surveillance, background investigations, law enforcement, military intelligence, legal investigations, journalism, cybersecurity, fraud analysis, or related fields is highly desirable.
Brand Protection Investigator Stellantis NVBrand Protection InvestigatorAuburn Hills, MIThis role plays a critical part in safeguarding our company's intellectual property, reputation, and consumer trust by identifying, investigating, and mitigating threats such as counterfeit parts, trademark infringements, illicit online sales, and gray-market distribution. You will conduct investigations across the supply chain, collaborate with cross-functional partners, and work closely with law enforcement and legal teams to protect our brands worldwide.
Field Investigator Burlington Stores IncField InvestigatorWauwatosa, WI$65,000–$80,000 / yearThe role collaborates closely with store and field asset protection teams and operational business partners to identify, analyze, and mitigate shortage risk through investigations as well as proactive measures to minimize opportunity for dishonest behaviors. Work cross-functionally with Asset Protection, Shortage Control, Safety, Store Operations, HR, Legal, and the Training and Development team in coordinating investigations, training efforts, and shortage and safety program compliance.
SIU Investigator Lead (Must live in OH or surrounding states) CareSource Management Services LLCSIU Investigator Lead (Must live in OH or surrounding states)Charleston, WVThis role is also responsible for the identification and monitoring of emerging FWA trends and conducting research and interactions on claims, industry and other sources (internal and external) of data and information to identify potential FWA and support ongoing fraud investigations. Act as the Program Integrity liaison and ensure collaboration with state and federal agencies and facilitate accurate deployment and ongoing monitoring of state-specific regulations and ongoing partnership with state regulators in managing Medicaid and Medicare programs.