Pharmacy Fraud Investigator-Remote

Remote Full-time
About the position Responsibilities • Oversee multiple investigations related to pharmacy and patient outreach. • Coordinate the successful transfer of essential case data between partners and the SIU. • Directly interact with multiple levels within partner organizations to manage Fraud, Waste, and Abuse activities. • Facilitate triage and coordination of partner fraud tips and communicate outcomes professionally. • Work with partner and SIU management to identify process improvement opportunities. • Understand back-end systems and reporting processes to troubleshoot gaps or issues. Requirements • College degree in a related field preferred or 3+ years of equivalent work experience. • Relevant experience as a Fraud Investigator in healthcare. • Certified Pharmacy Technician, Certified Fraud Examiner, or similar certification strongly desired. • Highly proficient in Microsoft Access & Excel, and data warehousing applications. • Excellent organizational and interpersonal skills, critical thinking and planning skills, verbal and written communication skills. Nice-to-haves • Ability to present to clients and internal stakeholders. • Ability to work well with senior management and high-level external contacts. • Ability to handle sensitive or confidential information critically. Benefits • 401(k) matching • Dental insurance • Health insurance • Life insurance • Paid holidays • Paid time off • Smoking cessation program • Tuition reimbursement • Minimum of 18 days of paid time off per year Apply tot his job
Apply Now →

Similar Jobs

Data Measurement & Reporting Senior Analyst (Medical Disruption) - Work at Home

Remote

Provider Contracting Lead Analyst - Cigna Healthcare - Morristown, NJ

Remote

[Hiring] Account Manager @091 Cigna Health & Life Ins. Co.

Remote

Disney Careers Remote – $20-25 An Hour (Apply Now) – Hire Me Remotely

Remote

Experienced Leader in Career Development Strategy – Disney Careers Remote Opportunity

Remote

Join Today: Teaching Artist; Seasonal (Disney Live Entertainment)

Remote

Technical Program Management Intern, Summer 2026

Remote

Senior Project Controls Estimator

Remote

Part-time Remote Editorial Assistant – Supporting Scientific Publishing Excellence

Remote

Book Designer (Fiction/Non-Fiction)

Remote

[Remote] Lead Product Manager - New User Experience & Growth

Remote

Test Engineer Security Clearance

Remote

Experienced Digital Data Entry and Market Research Participant - Remote Opportunity for Flexible, Part-Time or Full-Time Work

Remote

Remote Netflix Jobs - No Experience Needed ($/hr)

Remote

Experienced Full Stack Software Engineer – Web & Cloud Application Development at Blithequark

Remote

**Experienced Virtual Assistant / Airbnb Customer Support Specialist for Short-Term Rental Company - Contract to Hire Opportunity at blithequark**

Remote

Experienced Lead Director - Data Science, Patient Safety Analytics for Innovative Healthcare Solutions at CVS Health

Remote

Seasonal Retail Sales Associate - Lawrenceville Market - Delivering Exceptional Customer Experiences with Bath & Body Works

Remote

Remote Customer Support Agent — (Full-Time/Part-time / Flexible)

Remote

Recruitment Consultant

Remote
← Back