Humana Pharmacy Solutions, Inc.Hiring

Fraud and Waste Investigator

  • Remote, United States
  • Full-time
  • Mid-level
  • Posted 10 days ago
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In one line

Investigate fraud and waste in Medicaid claims, working with law enforcement and regulatory agencies to ensure program integrity.

About the role

The role involves analyzing billing practices, conducting audits, and preparing detailed reports to support investigations and recovery efforts.

At a glance

Pay
Not stated in the posting
Remote scope
Remote, United States
Seniority
Mid-level
Employment
Full-time
Skills
Data analysis
Posted
19 Oct 2026
Last checked
25 Oct 2026

What you will do

  • Conduct investigations of suspected fraud and waste in Medicaid claims.
  • Prepare detailed investigative reports for internal and external stakeholders.

What they look for

  • Bachelor's degree and clinical experience in multiple practice areas.
  • At least 2 years of healthcare fraud investigation experience.
  • Strong organizational, interpersonal, and communication skills.
  • Knowledge of healthcare payment methodologies.
  • Proficiency in MS Office tools.

Nice to have

  • Inquisitive nature with strong data analysis skills.

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Questions about this job

Can I do this job remotely, and from which countries?

The posting lists it as remote for people in the United States.

What does this job pay?

The posting does not state a salary, so there is no figure to quote.

What experience is needed?

It is a mid-level role. The posting asks for: bachelor's degree and clinical experience in multiple practice areas; at least 2 years of healthcare fraud investigation experience; strong organizational, interpersonal, and communication skills. Skills it names include Data analysis.

How do I apply with Keywordise AI?

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