UNKNOWN

FEED

This position will routinely handle high profile or highly sensitive matters involving cases that are national in scope, as well as, complex cases involving multi-lines of business, multiple subjects, or intricate healthcare fraud schemes. Strong communication skills, both written and oral, are necessary for the development and implementation of professional presentations for internal and external stakeholders regarding healthcare fraud matters and Enterprise approach to FWA.

YEAR

CVS Health offers a world of promising job opportunities across a diverse range of careers in everything from corporate and pharmacy roles to retails positions. No matter where you work at CVS Health, your unique skills, talents and abilities are welcome and valued. We recognize and reward greatness and want our employees to know their work is making a difference in the lives of millions. Join us today. Together we can continue making innovative, high-quality health and pharmacy services safe, affordable and accessible – for all.

CVS Health Corp

Senior Investigator, Special Investigations Unit (Aetna SIU)

CVS Health

Senior Investigator, Special Investigations Unit (SIU) - Must reside in Oklahoma

JOB SUMMARY: Our dynamic Ethos team is seeking a Special Unit Investigations (SIU) Field Investigator to conduct field investigations, gather and analyze evidence, and produce detailed reports that support claims decisions. Case Documentation: Conduct in-person interviews and obtain accurate, detailed statements from all parties involved, and retrieve relevant documents to support investigative findings.

Ethos Risk Services LLC

Special Investigations Unit (SIU) - Field Investigator

FULL_TIME

OTHER

Complies with the Veterans Affairs Community Care Network (CCN) and TRICARE T-5 contracts; DHA and TRICARE program guidelines and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, Military members and family (as warranted), providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals. The PI Investigator t is responsible for the identification, analysis, case development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA), the Healthcare Finance Administration (HCFA) and the Department of Defense, Defense Health Agency for the TRICARE program; requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).

TriWest Healthcare Alliance

Program Integrity Investigator

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Background Investigator, Level III - To qualify, applicants must have a bachelor's degree and one year of professional or technical administrative* experience in business or public administration plus one year of professional business or public administration experience; or an equivalent combination of education and experience, substituting one year of qualifying experience for each year of the required education. Background Investigator, Level II - To qualify, applicants must have a bachelor's degree and one year of professional or technical administrative* experience in business or public administration; or an equivalent combination of education and experience, substituting one year of qualifying experience for each year of the required education.

Oklahoma Human Services

Background Investigator I/II/III

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Searches for, identifies, collects, and labels any potential evidence/items from the fire scene, including devices used to set, start, or further the progress of fire; protects the chain of custody of potential evidence/items. Employee must be sharp, focused, and alert when conducting site inspections interacting with clients, preparing written reports of findings, and testifying in deposition or trial.

Rimkus

Fire Investigator

Workable

Rimkus Consulting Group is a world leader in forensic engineering and consulting with more than 60 offices across the United States, Canada, and the United Kingdom. For the past 35 years, Rimkus Consulting Group has been dedicated to the timely resolution of accidents, claims, and legal disputes.

In order to meet today’s complex challenges, Rimkus provides more than 500 professional engineers, scientists, and consulting experts who offer real-world expertise that spans across a broad spectrum of public and private environments. At Rimkus, our clients can count on us for timely delivery, clear communications, and scientifically correct and reliable answers to some very complex questions.

Rimkus Consulting Group

Work may involve standing, sitting, walking (even, uneven areas), occasional lifting (overhead, waist level) from floor, bending, frequent near vision use for reading and computer use. Work environment may involve exposure to various weather conditions, automotive fumes, fluids, noise, smells, sharp edges and bump hazards that require continuous use of personal protective equipment, i.e., safety glasses, gloves, and head protection.

V2X Inc

Automotive Product Investigator/Dealership Technician (Part-Time / On Call

Licenses/Certifications: Accredited Healthcare Fraud Investigator (AHFI), Certified Fraud Examiner (CFE), Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), or other related investigative, auditing, or compliance certification preferred. Collaborates with internal business partners, compliance, legal, provider and payment integrity teams, and external agencies to coordinate investigative activities, support corrective actions, recoveries, and case resolution efforts.

Centene Corporation Group

SIU Investigator

Located in Oklahoma City, a city that offers a dynamic and flourishing downtown area, with low cost of living, short commute times and a diversified economy, OMRF has been voted one of the Top Workplaces since the inception of the award. OMRF is dedicated to understanding and developing more effective treatments for human diseases, focusing on critical research areas such as Alzheimers disease, cancer, lupus, multiple sclerosis, and cardiovascular disease.

Oklahoma Medical Research Foundation

Research Technician I/II/III - Ahamed Lab

Ensure copies/originals (as required) site documents are available for filing in the Trial Master File (TMF) and verify that the Investigator's Site File (ISF) is maintained in accordance with GCP and local regulatory requirements. Create and maintain appropriate documentation regarding site management, monitoring visit findings and action plans by submitting regular visit reports, generating follow-up letters and other required study documentation.

IQVIA Holdings Inc

Clinical Research Associate, Sponsor Dedicated

Conducts simple research and laboratory analysis to include but not limited to measure and weigh compounds and solutions, isolate, identify and prepare specimens, and collect samples and other research data. Provides assistance to a research staff by conducting simple research experiments, collecting data and samples, keeping records, conducting literature searches, analyzing data, and preparing reports.

HOUR

University of Oklahoma

PEAK - Research Technician

PEAK - Research Technician - Luong Lab

The Research Nurse / Clinical Research Coordinator supports the clinical research mission of the Department of Surgery by coordinating the day-to-day operations of industry-sponsored and investigator-initiated clinical trials. This person will serve as a primary point of contact for study participants, ensuring that enrollment, consent, and data collection are conducted with rigor, compassion, and regulatory precision.

Sr. Clinical Research Nurse

Here, we employ techniques in bacteriology, biochemistry, molecular biology, eukaryotic cell culture and genetics to define the environmental signals that cue specific OMV production by Bacteroides and discern bacterial molecules within these OMVs that influence gut homeostasis and dysbiosis during health and disease as it relates to Cdif infection. Molecular biology, chemistry, and biochemistry techniques such as mechanical and chemical lysis of bacteria, membrane isolation, protein quantification, SDS-PAGE, glycolipid extraction and staining, and lipid extraction and analysis by thin-layer chromatography will be performed consistently.

Staff Research Assistant

As a key contributor to the SIU lead development process, this role evaluates provider, member, pharmacy, and ancillary healthcare billing patterns for signs of fraud, waste, abuse, and other anomalies. The Analyst II uses internal claims data, analytical tools, business rule results, and industry intelligence to assess potential FWA concerns and determine whether they warrant formal investigation.

Special Investigation Unit Lead Review Analyst II (Aetna SIU)

This is a field-based Medical Affairs position requiring a strong scientific background (technical or clinical experience) as the MSL will be a credible source of clinical/scientific data as well as technical/practical education to practicing clinicians, key opinion leaders (KOL), professional societies, and payers. A Medical Science Liaison (MSL) will serve as a liaison to the medical/scientific community and will be responsible for establishing, developing and maintaining relationships with key stakeholders within the geographic and therapeutic area of coverage.

Research Investigator Jobs in Oklahoma

Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health Corp

Senior Investigator, Special Investigations Unit (SIU) - Must reside in Oklahoma CVS Health

Special Investigations Unit (SIU) - Field Investigator Ethos Risk Services LLC

Program Integrity Investigator TriWest Healthcare Alliance

Background Investigator I/II/III Oklahoma Human Services

Fire Investigator Rimkus

Fire Investigator Rimkus Consulting Group

Automotive Product Investigator/Dealership Technician (Part-Time / On Call V2X Inc

SIU Investigator Centene Corporation Group

Research Technician I/II/III - Ahamed Lab Oklahoma Medical Research Foundation

Clinical Research Associate, Sponsor Dedicated IQVIA Holdings Inc

PEAK - Research Technician University of Oklahoma

PEAK - Research Technician - Luong Lab University of Oklahoma

Sr. Clinical Research Nurse University of Oklahoma

Staff Research Assistant University of Oklahoma

Special Investigation Unit Lead Review Analyst II (Aetna SIU) CVS Health

Medical Science Liason (MSL) - Podiatry, Men's Health and Ortho (Central) Mallinckrodt LLC

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