Fraud and Waste Investigator

At Humana, we are committed to protecting our members and ensuring the integrity of our healthcare system. As a Fraud and Waste Investigator, you will play a crucial role in detecting, investigating, and preventing fraudulent and wasteful activities within the company. This is a challenging and rewarding position that requires a keen eye for detail, strong analytical skills, and a passion for making a positive impact in the healthcare industry. If you are a proactive and driven individual with a background in investigative work and a desire to make a difference, we encourage you to apply for this exciting opportunity. Conduct thorough investigations into potential fraudulent and wasteful activities within Humana's healthcare system. Analyze data and documentation to identify patterns and inconsistencies that may indicate fraudulent or wasteful behavior. Utilize various tools and resources to gather evidence and build cases against individuals or entities suspected of fraud or waste. Collaborate with internal teams and external agencies to gather information and support investigations. Stay up-to-date on industry regulations and best practices related to fraud and waste prevention. Develop and implement strategies to proactively identify and prevent potential fraudulent and wasteful activities. Communicate findings and recommendations to management and relevant stakeholders. Work with legal teams to assist with legal proceedings related to fraud and waste cases. Maintain accurate and detailed records of investigations and outcomes. Train and educate other team members on fraud and waste detection and prevention methods. Adhere to ethical standards and maintain confidentiality in all aspects of the job. Continuously evaluate and improve processes and procedures related to fraud and waste investigations. Represent Humana in a professional manner and uphold the company's values and mission. Stay informed on emerging fraud and waste trends and adjust investigative techniques accordingly. Act as a subject matter expert and provide guidance and support to other departments as needed. Humana is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Apply tot his job