- Centene Corporation (Charleston, WV)
- …organization offering competitive benefits including a fresh perspective on workplace flexibility. ** Pharmacy FWA Investigator ** - Pharmacy Fraud, ... research specific FWA schemes. Recommends effective remedial actions of a pharmacy (eg, pharmacy network termination; corrective action plans) when a… more
- Molina Healthcare (Augusta, GA)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... settings) or 5+ years of experience working in a FWA / SIU or Fraud investigations role + Thorough...insurance, Medicare, Medicare Advantage, Medicare Part D, Medicaid, Tricare, Pharmacy , etc.) + Experience with UNET, Comet, Macess/CSP, or… more
- CVS Health (Trenton, NJ)
- …in the United States. We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU). In this role, you ... into suspected and known acts of healthcare fraud, waste and abuse ( FWA ). **Key Responsibilities** + Conduct high level, complex investigations of known or… more