Senior investigator full time jobs

Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that purpose. If you want to make a difference at the center of health, come join our innovative company and help us improve the lives of people and animals everywhere. Apply today! Job Details PRIMARY DUTIES AND RESPONSIBILITIES: 1. Responsible for Quality Assurance Investigations at ABC and ensuring adherence to applicable GMP regulations and policies and procedures. 2. Produces written reports that summarize the investigation, root cause determination, corrective actions and recommended disposition of affected product. 3. Conducts complaint investigations and maintains records of customer complaints. 4. Works with Production/QA to initiate investigations and minimize production down time. 5. Assists with the development of appropriate corrective actions. 6. Works with quality management to determine appropriate disposition of affected product. 7. Maintains the Investigation/CAPA Database and other databases as required. 8. Assists on follow-up checks on the effectiveness of corrective actions. 9. Performs other duties as assigned. EXPERIENCE AND EDUCATIONAL REQUIREMENTS: 1. BS in relevant Science or Engineering discipline. 2. At least 3 years of experience in a cGMP regulated environment 3. Must have a working knowledge of pharmaceutical packaging records, process and equipment; and experience in quality assurance in the pharmaceutical industry. MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS: 1. Strong critical thinking and deductive reasoning skills. 2. Strong oral, written, communication, presentation and interpersonal skills. 3. Ability to interact with Regulatory Agencies, vendors and all levels of associates within the organization, including management and plant associates. 4. Knowledge of QA principles, concepts, systems industry practices and standards. 5. Ability to work independently. 6. Ability to handle a variety of tasks simultaneously. 7. Attention to detail. 8. Strong skill in computer operations, experience with MS Word and Excel, ERP and Ensur) What Cencora offers We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members' ability to live with purpose every day. In addition to traditional offerings like medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. To encourage your personal growth, we also offer a variety of training programs, professional development resources, and opportunities to participate in mentorship programs, employee resource groups, volunteer activities, and much more. For details, visit ************************************** Full time Equal Employment Opportunity Cencora is committed to providing equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, veteran status or membership in any other class protected by federal, state or local law. The company's continued success depends on the full and effective utilization of qualified individuals. Therefore, harassment is prohibited and all matters related to recruiting, training, compensation, benefits, promotions and transfers comply with equal opportunity principles and are non-discriminatory. Cencora is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with legal requirements. If you wish to request an accommodation while seeking employment, please call ************ or email ****************. We will make accommodation determinations on a request-by-request basis. Messages and emails regarding anything other than accommodations requests will not be returned Affiliated CompaniesAffiliated Companies: Amerisource Health Services, LLC

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. **We are currently hiring for multiple positions. Candidates for these role must reside in one of the following states: CA, HI, IL, NE, and OH.** **Position Purpose:** Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse. + Conduct investigations of potential waste, abuse, and fraud + Document activity on each case and refer issues to the appropriate party + Perform data mining and analysis to detect aberrancies and outliers in claims + Develop new queries and reports to detect potential waste, abuse, and fraud + Provide case updates on progress of investigations and coordinate with Health Plans on recommendations and further actions and/or resolutions + Assist with complex allegations of healthcare fraud + Prepare summary and/or detailed reports on investigative findings for referral to Federal and State agencies + Complete various special projects and audits + Performs other duties as assigned + Complies with all policies and standards **Education/Experience:** Bachelor's Degree in Business, Criminal Justice, Healthcare, related field or equivalent experience. 1+ years of medical claim investigation, medical claim audit, medical claim analysis, or fraud investigation experience. Pay Range: $55,100.00 - $99,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Criminal Investigator 1 - Trumbull County (250008RP) Organization: Public Defender CommissionAgency Contact Name and Information: **************************** Unposting Date: Dec 15, 2025, 11:59:00 PMPrimary Location: United States of America-OHIO-Trumbull County Compensation: $53,602-$69,722Schedule: Full-time Classified Indicator: ClassifiedUnion: OCSEA Primary Job Skill: InvestigationTechnical Skills: Interviewing, InvestigationProfessional Skills: Attention to Detail, Building Trust, Critical Thinking, Establishing Relationships, Time Management Agency OverviewThe Office of the Ohio Public Defender (OPD) is the state agency responsible for providing legal representation and other services to people accused or convicted of a crime who cannot afford to hire an attorney.Our Mission: Advocating. Fighting. Helping.Our Vision: A Fair Justice System.Our Values: Compassion. Dignity. Equity. Integrity. Service. Community. We are committed to building a work environment where all team members have a voice and can embrace our differences to innovate service to the public in our pursuit of fairness and justice for all people.Follow OPD on Facebook, LinkedIn, Instagram, and Threads | Visit our WebsiteJob DutiesThe Office of the Ohio Public Defender is hiring for a Criminal Investigator 1 position. The position is headquartered in the Trumbull County Office of our Trial Services Division. As a Criminal Investigator 1, you will conduct criminal fact investigations of possible felonies and misdemeanors and assist in preparing and presenting cases at all levels of litigation including trials in Municipal, Juvenile, and Common Pleas Courts. The Trial Services Division provides client-centered representation to indigent clients facing criminal charges across the counties in Ohio. This position will conduct criminal investigations in cases in courts of Trumbull County. You will be based in Warren, Ohio, and will travel regularly within the county, and will spend time in the community, in jails, and in courthouses. You will work regularly with attorneys as a member of the defense team.Successful candidates will have passion for working with a large team and assisting people who are facing the challenges of poverty. The preferred candidate will have professional or volunteer experience helping to pursue a fair justice system.Essential functions of the position include but aren't limited to:Investigate the facts and circumstances of the alleged offense.Interview clients.Review case materials.Using a variety of tools, locate, contact, and interview witnesses in the field.Locate, contact, and interview other suspects and family members as needed.Gather physical and documentary evidence.Prepare and complete reports of interviews, findings, and timelines for use in trial.Gather documentation to support the testimony of expert and lay witnesses.View and diagram crime scenes.Assist in identifying records to put into evidence.Travel throughout Ohio and outside the state as necessary to locate and interview potential witnesses.Serve as a liaison to clients' families, law enforcement, various defense witnesses, and attorneys to transmit information.Meet regularly with others on defense team to provide updates on investigation and to collaborate with team members.Assist with mail, court runs, or filings.The Criminal Investigator 1 Position is assigned to the State of Ohio's OCSEA, Pay Range 30, presented below in table format. Starting pay will be at Step 1 unless required by contract/legislation; candidates with exceptional qualifications may be considered for higher starting pay. Our steps give a standard path for earnings growth: you move to the next step after 180 days and annually thereafter. We typically have fiscal year Cost of Living Adjustments as well.FY26 Pay Range 30 Step 1Step 2Step 3Step 4Step 5Step 6Step 7Hourly$25.77$26.76$27.92$29.22$60.55$31.88$33.52Annual$53,602$55,661$58,074$60,778$63,544$66,310$69,722The Office of the Ohio Public Defender complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If reasonable accommodation is needed to participate in the job application or interview process, please contact us at ************ or ******************** Work for the State of OhioAt the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes: Medical Coverage Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period Paid time off, including vacation, personal, sick leave and 11 paid holidays per year Childbirth, Adoption, and Foster Care leave Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more) Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) & Optional Deferred Compensation (Ohio Deferred Compensation) *Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.Qualifications12 mos. trg. or 12 mos. exp. in conducting investigations of complaints or possible violations of laws & rules or agency/company policies & procedures. -Or completion of associate degree program core coursework in law enforcement. Note: Positions in Ohio Bureau of Workers' Compensation may require use of proficiency demonstrations to determine Minimum Class Qualifications For Employment. -Or equivalent of Minimum Class Qualifications For Employment noted above. Job Skills: Investigation; Interviewing; Critical Thinking; Building Trust; Attention to Detail; Establishing Relationships; Time ManagementSupplemental InformationIntentional omission of relevant information, falsification, or misrepresentation of information on the application will disqualify the applicant. In addition, such intentional acts are grounds for immediate termination of an employee.Final candidates selected for this position will be required to undergo a drug test. An applicant with a positive test result will not be offered employment. Final candidates selected for this position will be required to undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position. An individual assessment of an applicant's prior criminal convictions will be made before excluding an applicant from consideration. ADA StatementOhio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.Drug-Free WorkplaceThe State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.

Job Description We have immediate openings due to growth. We are seeking experienced SIU/Claims Investigators in the Cleveland or surrounding areas. This is a part-time position to start with the ability to turn into a full-time position for the right individual. The owners are entrepreneurial, experienced, field investigators, each with over 25 years of experience. We understand the job and never forgot our roots in the field. We are dedicated professionals with a motivational management style with proven ability to recruit, develop and direct highly successful teams that consistently excel. Requirements: You must have complex SIU/Claims experience and reside in the Cleveland or surrounding area. If you do not have SIU/Claims experience, please do not apply because we can't hire you. Responsibilities: Provide detailed accurate reports Obtain written and recorded statements Perform scene investigations Ability to accurately photograph evidence i.e., accident scenes, vehicle damage, etc. Investigate property theft, vehicle theft, garaging issues and permissible use claims Skills/Experience: Experience conducting complex SIU/Claims cases is a must. Experience conducting surveillance as a Private Investigator is preferred but not required. Bi-lingual is a plus Associates/Bachelor, Degree in Criminal Justice or Related Field is a plus Notary license is a plus Ability and willingness to travel as necessary Flexibility to work varied/irregular hours and days Strong computer and Internet skills Possess a valid state-issued driver's license Possess a reliable vehicle, digital camera and computer with Windows Operating System, Microsoft Word and Internet connection Must have the personal pride to get your work product in on time Competitive starting pay Travel time compensation Report writing compensation FT positions are offered the following benefits: Medical, Dental, 401K, Paid Vacation and Paid Holidays

Corporate Security and Resilience Investigator II position will lead investigations, including Internal investigations of a sensitive nature. Position contributes to various types of investigations, including complex financial crime. This is achieved by providing an independent and objective investigation service enterprise wide that applies rigorous, lawful and professional practices and principles. Primary responsibilities include + Provide independent, professional, and objective investigative services to business stakeholders. + Delivering reliable, high-quality, fact-finding investigation reports that identify the relevant key issues and objective conclusions. + Identify key control issues by the gathering, analysis and objective interpretation of relevant complex evidence and by conducting formal and informational interviews with relevant employees. + Independent contact and engagement with suspects, victims and witnesses related to potential frauds/crimes. + Make determination on when to involve legal, human resources/employee relations, and senior management on sensitive incidents. + Ensure the delivery of work undertaken is consistent with and targeted to the issues subject to investigation and resolution + Provide court testimony as appropriate. + Makes determination if evidence is sufficient for criminal complaints. + Work independently on investigative actions while collaborating with local, state and federal law enforcement agencies on prosecution efforts. + Comply with all local, state and federal laws. + Ensure clear knowledge and understanding of SAR Program compliance. Qualifications, Education, Certifications and/or Other Professional Credentials + Five (3) years of relevant experience in similar investigations capacity. + Five (3) years of broker-dealer, compliance, financial or operational audits/investigations or related experience. + Knowledge of rules, regulations, and guidelines governing the securities industry. + Experience with social media, OSINT, payments, investments research + Knowledge of FINRA/SEC investigative best practices + Competence using a desktop computer with the full suite of office software applications. + Bachelor's degree in finance or related field + Certified Fraud Examiner certification preferred. Hours & Work Schedule Hours per Week: 40 Work Schedule: Monday - Friday. Work outside of normal business hours and overnight travel may be required. Pay Transparency The salary range for this position is $60,234 - $90,351 per year, plus an opportunity to earn an annual discretionary bonus. Actual pay is based on various factors including but not limited to the work location, and relevant skills and experience. We offer competitive pay, comprehensive medical, dental and vision coverage, retirement benefits, maternity/paternity leave, flexible work arrangements, education reimbursement, wellness programs and more. Note, Citizens' paid time off policy exceeds the mandatory, paid sick or paid time-away policy of very local and state jurisdiction in the United States. For an overview of our benefits, visit ************************************** . Some job boards have started using jobseeker-reported data to estimate salary ranges for roles. If you apply and qualify for this role, a recruiter will discuss accurate pay guidance. Equal Employment Opportunity Citizens, its parent, subsidiaries, and related companies (Citizens) provide equal employment and advancement opportunities to all colleagues and applicants for employment without regard to age, ancestry, color, citizenship, physical or mental disability, perceived disability or history or record of a disability, ethnicity, gender, gender identity or expression, genetic information, genetic characteristic, marital or domestic partner status, victim of domestic violence, family status/parenthood, medical condition, military or veteran status, national origin, pregnancy/childbirth/lactation, colleague's or a dependent's reproductive health decision making, race, religion, sex, sexual orientation, or any other category protected by federal, state and/or local laws. At Citizens, we are committed to fostering an inclusive culture that enables all colleagues to bring their best selves to work every day and everyone is expected to be treated with respect and professionalism. Employment decisions are based solely on merit, qualifications, performance and capability. Why Work for Us At Citizens, you'll find a customer-centric culture built around helping our customers and giving back to our local communities. When you join our team, you are part of a supportive and collaborative workforce, with access to training and tools to accelerate your potential and maximize your career growth Background Check Any offer of employment is conditioned upon the candidate successfully passing a background check, which may include initial credit, motor vehicle record, public record, prior employment verification, and criminal background checks. Results of the background check are individually reviewed based upon legal requirements imposed by our regulators and with consideration of the nature and gravity of the background history and the job offered. Any offer of employment will include further information.

Corporate Security and Resilience Investigator II position will lead investigations, including Internal investigations of a sensitive nature. Position contributes to various types of investigations, including complex financial crime. This is achieved by providing an independent and objective investigation service enterprise wide that applies rigorous, lawful and professional practices and principles. Primary responsibilities include * Provide independent, professional, and objective investigative services to business stakeholders. * Delivering reliable, high-quality, fact-finding investigation reports that identify the relevant key issues and objective conclusions. * Identify key control issues by the gathering, analysis and objective interpretation of relevant complex evidence and by conducting formal and informational interviews with relevant employees. * Independent contact and engagement with suspects, victims and witnesses related to potential frauds/crimes. * Make determination on when to involve legal, human resources/employee relations, and senior management on sensitive incidents. * Ensure the delivery of work undertaken is consistent with and targeted to the issues subject to investigation and resolution * Provide court testimony as appropriate. * Makes determination if evidence is sufficient for criminal complaints. * Work independently on investigative actions while collaborating with local, state and federal law enforcement agencies on prosecution efforts. * Comply with all local, state and federal laws. * Ensure clear knowledge and understanding of SAR Program compliance. Qualifications, Education, Certifications and/or Other Professional Credentials * Five (3) years of relevant experience in similar investigations capacity. * Five (3) years of broker-dealer, compliance, financial or operational audits/investigations or related experience. * Knowledge of rules, regulations, and guidelines governing the securities industry. * Experience with social media, OSINT, payments, investments research * Knowledge of FINRA/SEC investigative best practices * Competence using a desktop computer with the full suite of office software applications. * Bachelor's degree in finance or related field * Certified Fraud Examiner certification preferred. Hours & Work Schedule Hours per Week: 40 Work Schedule: Monday - Friday. Work outside of normal business hours and overnight travel may be required. Pay Transparency The salary range for this position is $60,234 - $90,351 per year, plus an opportunity to earn an annual discretionary bonus. Actual pay is based on various factors including but not limited to the work location, and relevant skills and experience. We offer competitive pay, comprehensive medical, dental and vision coverage, retirement benefits, maternity/paternity leave, flexible work arrangements, education reimbursement, wellness programs and more. Note, Citizens' paid time off policy exceeds the mandatory, paid sick or paid time-away policy of very local and state jurisdiction in the United States. For an overview of our benefits, visit *************************************** Some job boards have started using jobseeker-reported data to estimate salary ranges for roles. If you apply and qualify for this role, a recruiter will discuss accurate pay guidance. Equal Employment Opportunity Citizens, its parent, subsidiaries, and related companies (Citizens) provide equal employment and advancement opportunities to all colleagues and applicants for employment without regard to age, ancestry, color, citizenship, physical or mental disability, perceived disability or history or record of a disability, ethnicity, gender, gender identity or expression, genetic information, genetic characteristic, marital or domestic partner status, victim of domestic violence, family status/parenthood, medical condition, military or veteran status, national origin, pregnancy/childbirth/lactation, colleague's or a dependent's reproductive health decision making, race, religion, sex, sexual orientation, or any other category protected by federal, state and/or local laws. At Citizens, we are committed to fostering an inclusive culture that enables all colleagues to bring their best selves to work every day and everyone is expected to be treated with respect and professionalism. Employment decisions are based solely on merit, qualifications, performance and capability. Background Check Any offer of employment is conditioned upon the candidate successfully passing a background check, which may include initial credit, motor vehicle record, public record, prior employment verification, and criminal background checks. Results of the background check are individually reviewed based upon legal requirements imposed by our regulators and with consideration of the nature and gravity of the background history and the job offered. Any offer of employment will include further information. Benefits We offer competitive pay, comprehensive medical, dental and vision coverage, retirement benefits, maternity/paternity leave, flexible work arrangements, education reimbursement, wellness programs and more. View Benefits Awards We've Received Age-Friendly Institute's Certified Age-Friendly Employer Dave Thomas Foundation's Best Adoption-Friendly Workplace Disability:IN Best Places to Work for Disability Inclusion Human Rights Campaign Corporate Equality Index 100 Award Fair360 Top Regional Company FORTUNE's World's Most Admired Companies Military Friendly Employer

A Security Investigator conducts routine to complex investigations involving fraud and/or physical security considerations. Security Investigators work closely with Security Department analysts in a collaborative environment and are expected to maintain a professional and positive working relationship with internal and external partners, including law enforcement agencies and other financial institutions. Security Investigators may also serve as support and response personnel as part of enterprise physical security strategies. Education and Experience Requirements: Bachelor's degree in criminal justice, accounting, finance, pre-law, or other related field required. Will consider commensurate experience. Minimum 1 year experience required in conducting investigations involving fraud and/or physical security. Experience with and understanding financial transactions is preferred. Certificate, Licenses and Registration Requirements: N/A Knowledge, Skill, and Ability Requirements: Solid understanding of financial fraud investigations and physical security systems is a plus. The ability to proficiently and effectively navigate multiple software systems simultaneously. Must be able to differentiate and transition from proactive problem identification to root cause analysis. Excellent written and verbal skills are necessary to interact and communicate with various levels of internal and external clients. Must be able to effectively work independently or in a team environment. Excellent time management and organizational skills with the ability to manage and prioritize multiple tasks to meet predetermined deadlines. Solid understanding of financial fraud investigations and physical security systems is a plus. Essential Functions: Conduct routine to complex investigations as identified or assigned that may involve variables such as checks, digital, electronic, identity theft, card, loans, and physical properties. Conduct interviews in accordance with Bank expectations and laws of the jurisdiction that support Bank investigations. Preparation of Suspicious Activity Reports (SARs) and organization of case data and other supporting documentation. Ability to understand, compile, and report on industry fraud trends and associated operational impacts contributing to potential fraud loss. Implement, maintain, and respond to physical security strategies and associated equipment performance within a geographical area. Be part of the Department's 24/7 emergency and investigative response team for security related matters including responding to intrusion alarms. Travel to Bank properties as needed as part of investigations or interviews and conduct other duties as assigned. All employees have the responsibility and the accountability to serve as risk managers for their businesses by understanding, reporting, responding to, managing and monitoring the risk they encounter daily as required by Dollar Bank's risk management program. Compliance with regulatory laws and company procedures is a required component of all position descriptions. Supervisory Responsibilities: N/A Schedule Information M-F 8:00am-5:00pm EEO Statement Dollar Bank is an Equal Opportunity Employer. Minority/Female/Veteran/Disabled Benefits Information Full-time employees are eligible for a comprehensive benefits package including medical, dental, vision, 401(k) with immediate vesting, tuition reimbursement, and gym membership reimbursement. Part-time employees qualify for 401(k) with immediate vesting, tuition reimbursement, and gym reimbursement. For more information, please visit ************************************************

The Market Investigator is responsible for confirming that the market's stores operations and daily functions comply with Company programs and policies. Monitor and measure store process performance in these categories: Office/Cash Sales, Loss Prevention, Physical Security, Safety and Personnel Training and Development. This position will report directly to the Director, Loss Prevention or Regional Manager, Loss Prevention and will interface frequently with Field Managers and Corporate Business Partners. Principal Duties & Responsibilities: + Conduct Monthly Stores LP Audit and score store performance based on specific criteria. Report audit findings to Store Manager, Field Manager and Corporate Management. + Advise and consult with Store Managers on improving the in-store experience based on store audits. + Train Store Managers on Family Dollar procedure and compliance to include Cash Management, Loss Prevention, Physical Security, Safety, Robbery Prevention, Product Freshness and Display Compliance. Assist Store Managers in training their Team Members in these areas. + Plan and facilitate storewide meetings to review procedures/policies with Asset Protection Specialists (APS), store Team Members and Store Managers. + Proficiently utilize exception reporting (XBR & SAER) and partnership with Corporate Sales Audit Department to monitor District Cash and Sales (OIS) losses and investigate cash or inventory loss trends. + Monitor and manage District's Target Program and weekly exception reporting to improve the market's stores inventory results. + Conducts in store surveillances using Loss Prevention tools I-Verify and DVR to identify and escalate potential internal integrity issues, safety concerns, fines, lost sales and others. + Conducts Loss Prevention Quality Store Visits (LPQSV) including Honesty Conversations with store's team members. + Ensure that Store's Asset Protection Equipment is in good working order and is being utilized effectively, including: CCTV, Interactive CCTV, Exit Alarms, Burglar Alarms, Safes, Drop Boxes and Checkpoint. + Report suspected fraudulent activity to Loss Prevention Business Partners. + Assist with special projects that impact given market (i.e. Target Program and Shrink Impact Stores) + Follows and assures the implementation of all Company Policies and Procedures. + All other projects/duties as assigned. Minimum Requirements: Education: Completion of high school or equivalent; college preferred. Ability to read, interpret and explain to others operational directives (e.g., merchandise schematics, etc.). Experience: Prefer store management experience in retail, grocery or drug store environments. Field experience in local market and/or loss prevention training a plus. Previous experience facilitating large group training sessions. Requirements: Proven organizational, analytical and problem-solving skills. Intermediate Microsoft Office proficiency (Outlook, Word, Excel and Access.). Ability to travel locally and overnight as needed. Valid Driver's License Availability: Ability to work flexible, full-time schedule to include days, evenings, weekends and holidays. The pay for this role will be in the range of $70,700 - $74,400, with the actual pay being based on experience. We value our Associates' contributions to our success, which drives us to invest in the most important element of our organization: our people. As we work towards a healthier future, we provide eligible associates with the following: Health and welfare programs including medical, pharmacy, dental, and vision Employee Assistance Program Paid Time Off Retirement Plans Full time 455 Colemans Xing,Marysville,Ohio 43040-7068 Asset Protection Family Dollar 70500 89500

Special Investigations Unit (SIU) Investigator SummaCare - 1200 E Market St, Akron, OH Full-Time / 40 Hours / Days Hybrid / Remote Protect Integrity. Uncover the Truth. Join Us as an FWA Investigator! Are you fueled by curiosity, driven by justice, and relentless in your pursuit of the facts? Step into a high-impact role where your investigative skills help safeguard healthcare systems from fraud, waste, and abuse - and ensure that resources go where they're truly needed. We're looking for a Fraud, Waste, and Abuse (FWA) Investigator to lead complex investigations, analyze patterns, ensure compliance, communicate via phone or in writing with members and providers and collaborate across teams to uphold compliance and accountability. Summary: Conducts medium to high complexity investigations under general supervision to effectively pursue the identification, prevention, and investigation of healthcare fraud, waste and abuse (FWA), to facilitate the recovery of lost funds, and to comply with state and federal regulations mandating fraud plans and practices. Maintains knowledge of current schemes and determines impact to the plan. Ensures the SIU processes and procedures reflect current industry norms. Formal Education Required: a. Bachelor's Degree, or equivalent combination of education and experience. Experience & Training Required: a. Five (5) years Fraud, Waste and Abuse identification and investigation. b. Special Investigations Unit (SIU) experience in a managed care setting. Essential Functions: 1) Works within industry groups, and known fraud, waste and abuse (FWA) data repositories to ensure a current knowledge and understanding of FWA schemes and industry practices. 2) Performs data mining to determine if identified FWA schemes are impacting the plan, summarize those findings and make recommendations for action including reporting and prevention. Documents all findings, decisions, and actions. 3) Maintains working knowledge of relative enterprise and local information systems, databases, data schemas, software packages, and business operations to facilitate precise, reliable and accurate fulfillment of information needs related to corporate operations. 4) Maintains employee, provider and member education as it relates to FWA. 5) Investigates assigned cases of FWA including coordinating and conducting on-site and desk-top audits, member and stakeholder interviews, outlier billing identification, contract and regulatory guidance analysis. 6) Manages the SIU prepay review process which includes requesting the implementation of prepay reviews, organizing the records, and reviewing submitted records or sending to the appropriate area for a medical/coding review. 7) Complies with SIU Policies and procedures as well as goals set by SIU leadership. 8) Prepares SIU documentation for arbitrations, legal procedures, and settlements. 9) Recommends claim handling based on medical record review and compliance with industry standard claim coding (CPT, HCPCs, ICD10. etc,) and payment policies. 10) Ability to effectively interact with populations of patients/customers with an understanding of their needs for self-respect and dignity. 3. Other Skills, Competencies and Qualifications: a. Demonstrate intermediate proficiency in MS Office, Project, and database management. b. Maintain excellent working knowledge of process improvement techniques, methodologies and principles applying these in the normal course of operations. c. Demonstrate excellent analytical and problem-solving skills. d. Apply principles of logical thinking to define problems, collect data, establish facts, and draw valid conclusions. e. Organize and manage time to accurately complete tasks within designated time frames in fast paced environment. f. Skilled at conducting analysis of claims data to identify aberrant patterns and support investigative activities. g. Maintain current knowledge of and comply with regulatory and company policy and procedures. h. Accredited Healthcare Fraud Investigator (AHFI) or Certified Fraud Examiner (CFE) preferred. i. Lean Six Sigma Yellow Belt preferred 4. Level of Physical Demands: a. Sit for prolonged periods of time. b. Bend, stoop, and stretch. c. Lift up to 20 pounds. d. Manual dexterity to operate computer, phone, and standard office machines As a regional, provider-owned health plan, SummaCare values the relationship between the members and their doctors. SummaCare is a part of Summa Health, an integrated healthcare delivery system that includes Summa Health System hospitals, its community-based health centers, dedicated clinicians and SummaCare. Based in Akron, Ohio, SummaCare provides Medicare Advantage, individual and family and commercial insurance plans. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2025 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits. Equal Opportunity Employer/Veterans/Disabled $28.10/hr - $42.15/hr The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical. Summa Health offers a competitive and comprehensive benefits program to include medical, dental, vision, life, paid time off as well as many other benefits. * Basic Life and Accidental Death & Dismemberment (AD&D) * Supplemental Life and AD&D * Dependent Life Insurance * Short-Term and Long-Term Disability * Accident Insurance, Hospital Indemnity, and Critical Illness * Retirement Savings Plan * Flexible Spending Accounts - Healthcare and Dependent Care * Employee Assistance Program (EAP) * Identity Theft Protection * Pet Insurance * Education Assistance * Daily Pay

Remote - Florida Remote - Georgia Remote - North Carolina Remote - Ohio Remote - Oklahoma Remote - Pennsylvania Remote - South Carolina Remote - Tennessee Remote - Texas Work Arrangement: This is a remote, work-from-home opportunity for candidates located in one our eligible states. The role includes three weeks of company-provided remote training. Please note: Remote work flexibility is not guaranteed long-term and may be subject to change based on company needs. (Candidates must currently reside in Arizona, Florida, Georgia, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, or Texas). About the Role: As a Senior AML Investigator, you'll work remotely to provide expertise in detecting suspicious financial activity, ensuring regulatory compliance, and performing quality control. You will lead investigations, supervise junior analysts, and collaborate with clients to manage financial crime risks. This role offers the opportunity to work independently while making key decisions in a fast-paced, dynamic environment. Key Responsibilities: Identify data anomalies and red flags related to money laundering, terrorist financing, fraud, and sanctions violations, escalating cases for second-level review as appropriate. Verify client identities to understand the nature and purpose of their relationship with the financial institution, ensuring compliance with Know Your Customer (KYC) procedures. Perform quality control (QC) tasks as needed. Assist with advanced responsibilities, including client communication, analyzing production data, and developing client-specific aids and training materials. Provide independent support to analysts with workflow items and administrative tasks as they arise. Submit written work for review by internal and client quality control teams, make necessary adjustments based on feedback, and apply insights to future work. Meet all designated deadlines and procedures to ensure accurate and timely completion of tasks. Contribute to a collaborative, team-oriented work environment. Comply with all relevant federal and state laws, regulations, and guidance, including Anti-Money Laundering (AML) requirements, as well as company policies, procedures, and client expectations. What You Bring (Minimum Qualifications) Bachelor's degree is required. At least 2-3 years of relevant AML/BSA experience. Must currently reside in Arizona, Florida, Georgia, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, or Texas Ability to thoroughly investigate potentially suspicious activities, analyze findings, and prepare detailed Suspicious Activity Reports (SARs) in compliance with regulatory requirements and clients' internal policies. Strong knowledge of financial or banking industries and related regulations and laws. Strong written and oral communication skills with the ability to produce narrative or written summaries clearly synthesizing recommendations and conclusions. Proven ability to consistently meet and exceed daily production goals, demonstrating strong time management skills, attention to detail, and the capacity to prioritize tasks effectively. Strong analytical, problem solving and organizational skills. Proficiency in Microsoft Excel, PowerPoint, and Word, with a demonstrated ability to quickly learn new technologies. Demonstrated experience in MS Excel, including pivot tables, macros, filtering, and sorting. Capable of multitasking, working independently, and collaborating as part of a team to establish cooperative and productive working relationships. Receptive to feedback and able to implement changes effectively. Quick learner with adaptability to new technologies and processes. Normal Working Hours and Conditions: Core hours are 8:00 am - 5:00 pm, with potential flexibility required based on operational needs across different time zones. About Us: We are AML RightSource, the leading technology-enabled managed services firm focused on fighting financial crime for our clients and the world. Headquartered in Cleveland, Ohio, and operating across the globe, we are a trusted partner to our financial institution, FinTech, money service business, and corporate clients. Using a blend of highly trained anti-financial crime professionals, cutting-edge technology tools, and industry-leading consultants, we help clients with their AML/BSA, transaction monitoring, client onboarding (KYC), enhanced due diligence (EDD), and risk management needs. We support clients in meeting day-to-day compliance tasks, urgent projects, and strategic changes. Globally, our staff of more than 7,000 highly trained analysts and subject matter experts is the industry's largest group of full-time compliance professionals. Together with our clients, we are Reimagining Compliance. Physical Requirements: Ability to sit or stand for long periods. Prolonged use of computers and office equipment. Occasional lifting, bending, and reaching required. AML RightSource is committed to fostering a diverse work environment and is proud to be an equal opportunity employer. We provide equal employment opportunities to all qualified applicants without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. Recruitment Scam Alerts We're aware of an increase in recruitment scams where individuals falsely claim to represent AML RightSource. These scammers may ask for money or personal information by offering fake job opportunities through e-mail, text message or social media. Please verify the source of any job-related communications carefully. All official AML RightSource communications are conducted through "@amlrightsource.com" email addresses. If you encounter suspicious messages, do not respond.

Job DescriptionField Investigator / Camera Car Driver / Spotter Euclide OH Schedule: Monday - Friday / 4a.m-12p.m Sunday - Thursday / 7p.m - 3a.m InterLink is seeking a dependable and motivated Camera Car Driver/Repossession Field Investigator to join our team! This role is responsible for identifying and locating vehicles that are out for repossession. This position is crucial to our company and we are looking for the best in the industry! Vehicle equipped with an iPad and license plate recognition system provided. We offer a full benefits package to full-time employees and a competitive base wage plus commission! Room for growth!!! $15/hr + commission for each vehicle that is spotted and secured. Camera Car Driver - Spotter/Repossession Field Investigator Responsibilities: Drive for 8 hours/shift in designated zone to attempt to locate vehicles at specific addresses Identify and take photos of vehicles Collect license plate data and verify vehicle identification numbers (VIN) Report vehicle location and data to InterLink team Pick-up and drop off company vehicle before and after shift Assisting agents with acceptance of assignments during non-office hours Camera Car Driver/Spotter - Repossession Field Investigator Requirements: Valid driver's license with clean driving record Be able to pass a criminal background check/no felonies Be able to pass a drug screen Basic computer skills Attention to detail Sense of urgency and self motivated/able to work on your own Ability to pass a required certification course Prior experience in a driving profession desired: cab driver, delivery drivers of any kind Benefits for full-time employees: Competitive compensation Health insurance Paid time off Paid training Opportunities for career growth and development Powered by JazzHR oJmpPr7oEy

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Position Summary** As a Senior Investigator you will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive or high profile, those that are national in scope, complex cases, or cases involving multiple perpetrators or intricate healthcare fraud schemes. + Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business + Researches and prepares cases for clinical and legal review + Documents all appropriate case activity in case tracking system + Facilitates feedback with providers related to clinical findings + Initiates proactive data mining to identify aberrant billing patterns + Makes referrals, both internal and external, in the required timeframe + Facilitates the recovery of money lost as a result of fraud matters + Provides on the job training to new Investigators and provides guidance for less experienced or skilled Investigators. + Assists Investigators in identifying resources and best course of action on investigations + Serves as back up to the manager as necessary + Cooperates with federal, state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters. + Demonstrates high level of knowledge and expertise during interactions and acts confidently when providing testimony during civil and criminal proceedings + Gives presentations to internal and external customers regarding healthcare fraud matters and Aetna's approach to fighting fraud + Provides input regarding controls for monitoring fraud related issues within the business units **Required Qualifications** + Must live in the state of Ohio + 4+ years investigative experience in the area of healthcare fraud, waste and abuse matters. + Working knowledge of medical coding; CPT, HCPCS, ICD10 + Proficiency in Microsoft Office with advanced skills in Excel (must know how to do pivot tables). + Strong analytical and research skills. + Proficient in researching information and identifying information resources. + Strong verbal and written communication skills. + The ability to understand and analyze health care claims and coding + Ability to travel up to 10% (approx. 2-3x per year, depending on business needs) **Preferred Qualifications** + Previous Medicaid/Medicare investigatory experience + Previous Behavioral Health experience + Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations for fraud and abuse. + Credentials such as certification from the Association of Certified Fraud Examiners (CFE), or an accreditation from the National Health Care Anti-Fraud Association (AHFI) + Knowledge of Aetna's policies and procedures. + Knowledge and understanding of complex clinical issues. + Competent with legal theories. + Strong communication and customer service skills. + Ability to effectively interact with different groups of people at different levels in any situation. **Education** Bachelor's degree or equivalent experience ( A bachelor's degree, or an associate's degree with an additional four+ years working on health care fraud, waste, and abuse investigations and audits; **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $46,988.00 - $91,800.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 12/18/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

We have immediate openings due to growth. We are seeking experienced SIU/Claims Investigators in the Cleveland or surrounding areas. This is a part-time position to start with the ability to turn into a full-time position for the right individual. The owners are entrepreneurial, experienced, field investigators, each with over 25 years of experience. We understand the job and never forgot our roots in the field. We are dedicated professionals with a motivational management style with proven ability to recruit, develop and direct highly successful teams that consistently excel. Requirements: You must have complex SIU/Claims experience and reside in the Cleveland or surrounding area. If you do not have SIU/Claims experience, please do not apply because we can't hire you. Responsibilities: Provide detailed accurate reports Obtain written and recorded statements Perform scene investigations Ability to accurately photograph evidence i.e., accident scenes, vehicle damage, etc. Investigate property theft, vehicle theft, garaging issues and permissible use claims Skills/Experience: Experience conducting complex SIU/Claims cases is a must. Experience conducting surveillance as a Private Investigator is preferred but not required. Bi-lingual is a plus Associates/Bachelor, Degree in Criminal Justice or Related Field is a plus Notary license is a plus Ability and willingness to travel as necessary Flexibility to work varied/irregular hours and days Strong computer and Internet skills Possess a valid state-issued driver's license Possess a reliable vehicle, digital camera and computer with Windows Operating System, Microsoft Word and Internet connection Must have the personal pride to get your work product in on time Competitive starting pay Travel time compensation Report writing compensation FT positions are offered the following benefits: Medical, Dental, 401K, Paid Vacation and Paid Holidays

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryAs a Senior Investigator you will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive or high profile, those that are national in scope, complex cases, or cases involving multiple perpetrators or intricate healthcare fraud schemes. Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business Researches and prepares cases for clinical and legal review Documents all appropriate case activity in case tracking system Facilitates feedback with providers related to clinical findings Initiates proactive data mining to identify aberrant billing patterns Makes referrals, both internal and external, in the required timeframe Facilitates the recovery of money lost as a result of fraud matters Provides on the job training to new Investigators and provides guidance for less experienced or skilled Investigators. Assists Investigators in identifying resources and best course of action on investigations Serves as back up to the manager as necessary Cooperates with federal, state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters. Demonstrates high level of knowledge and expertise during interactions and acts confidently when providing testimony during civil and criminal proceedings Gives presentations to internal and external customers regarding healthcare fraud matters and Aetna's approach to fighting fraud Provides input regarding controls for monitoring fraud related issues within the business units Required QualificationsMust live in the state of Ohio4+ years investigative experience in the area of healthcare fraud, waste and abuse matters. Working knowledge of medical coding; CPT, HCPCS, ICD10Proficiency in Microsoft Office with advanced skills in Excel (must know how to do pivot tables). Strong analytical and research skills. Proficient in researching information and identifying information resources. Strong verbal and written communication skills. The ability to understand and analyze health care claims and coding Ability to travel up to 10% (approx. 2-3x per year, depending on business needs) Preferred QualificationsPrevious Medicaid/Medicare investigatory experience Previous Behavioral Health experience Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations for fraud and abuse. Credentials such as certification from the Association of Certified Fraud Examiners (CFE), or an accreditation from the National Health Care Anti-Fraud Association (AHFI) Knowledge of Aetna's policies and procedures. Knowledge and understanding of complex clinical issues. Competent with legal theories. Strong communication and customer service skills. Ability to effectively interact with different groups of people at different levels in any situation. EducationBachelor's degree or equivalent experience ( A bachelor's degree, or an associate's degree with an additional four+ years working on health care fraud, waste, and abuse investigations and audits; Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$46,988. 00 - $91,800. 00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 12/18/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Position Summary** - Conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply with state regulations mandating fraud plans and practices. - Conducts investigations of known or suspected acts of healthcare fraud and abuse. - Communicates with federal, state, and local law enforcement agencies as appropriate in matters pertaining to the prosecution of specific healthcare fraud cases. - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, customer members, etc. - Facilitates the recovery of company and customer money lost as a result of fraud matters. - Provides input regarding controls for monitoring fraud related issues within the business units. - Delivers educational programs designed to promote deterrence and detection of fraud and minimize losses to the company - Maintains open communication with constituents within and external to the company. - Uses available resources and technology in developing evidence, supporting allegations of fraud and abuse. - Researches and prepares cases for clinical and legal review. - Documents all appropriate case activity in tracking system. - Makes referrals and deconflictions, both internal and external, in the required timeframe. - Cost effectively manages use of outside resources and vendors to perform activities necessary for investigations. - Exhibits behaviors outlined in Employee Competencies - Attending and presenting at quarterly state meetings. **Required Qualifications** - 1+ years' experience working with Medicaid. - 3+ years' in healthcare field working in fraud, waste and abuse investigations and audits. - Proficient in researching information and identifying information resources. - Experience working in Microsoft Word, Excel, Outlook products. - Experience working with database search tools and use in the Intranet/Internet to research information. - Ability to utilize company systems to obtain relevant electronic documentation. - Ability to travel and participate in legal proceedings, arbitrations, depositions, etc. **Preferred Qualifications** - Knowledge of New Jersey Medicaid - Credentials such as a certification from the Association of Certified Fraud Examiners (CFE) - An accreditation from the National Health Care Anti-Fraud Association (AHFI). - Billing and Coding certifications such as CPC (AAPC) and/or CCS (AHIMA) - Knowledge of Aetna's policies and procedures - Ability to interact with different groups of people at different levels and provide assistance on a timely basis. **Education** - Bachelor's degree and/or an Associate's degree with three additional years working in health care fraud, waste, and abuse investigations and audits. **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $46,988.00 - $122,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 01/10/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary- Conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply with state regulations mandating fraud plans and practices. - Conducts investigations of known or suspected acts of healthcare fraud and abuse. - Communicates with federal, state, and local law enforcement agencies as appropriate in matters pertaining to the prosecution of specific healthcare fraudcases. - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, customer members, etc. - Facilitates the recovery of company and customer money lost as a result of fraud matters. - Provides input regarding controls for monitoring fraud related issues within the business units. - Delivers educational programs designed to promote deterrence and detection of fraud and minimize losses to the company- Maintains open communication with constituents within and external to the company. - Uses available resources and technology in developing evidence, supporting allegations of fraud and abuse. - Researches and prepares cases for clinical and legal review. - Documents all appropriate case activity in tracking system. - Makes referrals and deconflictions, both internal and external, in the required timeframe. - Cost effectively manages use of outside resources and vendors to perform activities necessary for investigations. - Exhibits behaviors outlined in Employee Competencies- Attending and presenting at quarterly state meetings. Required Qualifications- 1+ years' experience working with Medicaid. - 3+ years' in healthcare field working in fraud, waste and abuse investigations and audits. - Proficient in researching information and identifying information resources. - Experience working in Microsoft Word, Excel, Outlook products. - Experience working with database search tools and use in the Intranet/Internet to research information. - Ability to utilize company systems to obtain relevant electronic documentation. - Ability to travel and participate in legal proceedings, arbitrations, depositions, etc. Preferred Qualifications- Knowledge of New Jersey Medicaid- Credentials such as a certification from the Association of Certified Fraud Examiners (CFE)- An accreditation from the National Health Care Anti-Fraud Association (AHFI). - Billing and Coding certifications such as CPC (AAPC) and/or CCS (AHIMA)- Knowledge of Aetna's policies and procedures- Ability to interact with different groups of people at different levels and provide assistance on a timely basis. Education- Bachelor's degree and/or an Associate's degree with three additional years working in health care fraud, waste, and abuse investigations and audits. Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$46,988. 00 - $122,400. 00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 01/10/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary- Conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply with state regulations mandating fraud plans and practices. - Conducts investigations of known or suspected acts of healthcare fraud and abuse. - Communicates with federal, state, and local law enforcement agencies as appropriate in matters pertaining to the prosecution of specific healthcare fraudcases. - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, customer members, etc. - Facilitates the recovery of company and customer money lost as a result of fraud matters. - Provides input regarding controls for monitoring fraud related issues within the business units. - Delivers educational programs designed to promote deterrence and detection of fraud and minimize losses to the company- Maintains open communication with constituents within and external to the company. - Uses available resources and technology in developing evidence, supporting allegations of fraud and abuse. - Researches and prepares cases for clinical and legal review. - Documents all appropriate case activity in tracking system. - Makes referrals and deconflictions, both internal and external, in the required timeframe. - Cost effectively manages use of outside resources and vendors to perform activities necessary for investigations. - Exhibits behaviors outlined in Employee Competencies- Attending and presenting at quarterly state meetings. Required Qualifications- 1+ years' experience working with Medicaid. - 3+ years' in healthcare field working in fraud, waste and abuse investigations and audits. - Proficient in researching information and identifying information resources. - Experience working in Microsoft Word, Excel, Outlook products. - Experience working with database search tools and use in the Intranet/Internet to research information. - Ability to utilize company systems to obtain relevant electronic documentation. - Ability to travel and participate in legal proceedings, arbitrations, depositions, etc. Preferred Qualifications- Knowledge of New Jersey Medicaid- Credentials such as a certification from the Association of Certified Fraud Examiners (CFE)- An accreditation from the National Health Care Anti-Fraud Association (AHFI). - Billing and Coding certifications such as CPC (AAPC) and/or CCS (AHIMA)- Knowledge of Aetna's policies and procedures- Ability to interact with different groups of people at different levels and provide assistance on a timely basis. Education- Bachelor's degree and/or an Associate's degree with three additional years working in health care fraud, waste, and abuse investigations and audits. Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$46,988. 00 - $122,400. 00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 01/10/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary- Conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply with state regulations mandating fraud plans and practices. - Conducts investigations of known or suspected acts of healthcare fraud and abuse. - Communicates with federal, state, and local law enforcement agencies as appropriate in matters pertaining to the prosecution of specific healthcare fraudcases. - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, customer members, etc. - Facilitates the recovery of company and customer money lost as a result of fraud matters. - Provides input regarding controls for monitoring fraud related issues within the business units. - Delivers educational programs designed to promote deterrence and detection of fraud and minimize losses to the company- Maintains open communication with constituents within and external to the company. - Uses available resources and technology in developing evidence, supporting allegations of fraud and abuse. - Researches and prepares cases for clinical and legal review. - Documents all appropriate case activity in tracking system. - Makes referrals and deconflictions, both internal and external, in the required timeframe. - Cost effectively manages use of outside resources and vendors to perform activities necessary for investigations. - Exhibits behaviors outlined in Employee Competencies- Attending and presenting at quarterly state meetings. Required Qualifications- 1+ years' experience working with Medicaid. - 3+ years' in healthcare field working in fraud, waste and abuse investigations and audits. - Proficient in researching information and identifying information resources. - Experience working in Microsoft Word, Excel, Outlook products. - Experience working with database search tools and use in the Intranet/Internet to research information. - Ability to utilize company systems to obtain relevant electronic documentation. - Ability to travel and participate in legal proceedings, arbitrations, depositions, etc. Preferred Qualifications- Knowledge of New Jersey Medicaid- Credentials such as a certification from the Association of Certified Fraud Examiners (CFE)- An accreditation from the National Health Care Anti-Fraud Association (AHFI). - Billing and Coding certifications such as CPC (AAPC) and/or CCS (AHIMA)- Knowledge of Aetna's policies and procedures- Ability to interact with different groups of people at different levels and provide assistance on a timely basis. Education- Bachelor's degree and/or an Associate's degree with three additional years working in health care fraud, waste, and abuse investigations and audits. Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$46,988. 00 - $122,400. 00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 01/10/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary- Conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply with state regulations mandating fraud plans and practices. - Conducts investigations of known or suspected acts of healthcare fraud and abuse. - Communicates with federal, state, and local law enforcement agencies as appropriate in matters pertaining to the prosecution of specific healthcare fraudcases. - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, customer members, etc. - Facilitates the recovery of company and customer money lost as a result of fraud matters. - Provides input regarding controls for monitoring fraud related issues within the business units. - Delivers educational programs designed to promote deterrence and detection of fraud and minimize losses to the company- Maintains open communication with constituents within and external to the company. - Uses available resources and technology in developing evidence, supporting allegations of fraud and abuse. - Researches and prepares cases for clinical and legal review. - Documents all appropriate case activity in tracking system. - Makes referrals and deconflictions, both internal and external, in the required timeframe. - Cost effectively manages use of outside resources and vendors to perform activities necessary for investigations. - Exhibits behaviors outlined in Employee Competencies- Attending and presenting at quarterly state meetings. Required Qualifications- 1+ years' experience working with Medicaid. - 3+ years' in healthcare field working in fraud, waste and abuse investigations and audits. - Proficient in researching information and identifying information resources. - Experience working in Microsoft Word, Excel, Outlook products. - Experience working with database search tools and use in the Intranet/Internet to research information. - Ability to utilize company systems to obtain relevant electronic documentation. - Ability to travel and participate in legal proceedings, arbitrations, depositions, etc. Preferred Qualifications- Knowledge of New Jersey Medicaid- Credentials such as a certification from the Association of Certified Fraud Examiners (CFE)- An accreditation from the National Health Care Anti-Fraud Association (AHFI). - Billing and Coding certifications such as CPC (AAPC) and/or CCS (AHIMA)- Knowledge of Aetna's policies and procedures- Ability to interact with different groups of people at different levels and provide assistance on a timely basis. Education- Bachelor's degree and/or an Associate's degree with three additional years working in health care fraud, waste, and abuse investigations and audits. Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$46,988. 00 - $122,400. 00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 01/10/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.