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Senior Fraud and Waste Investigator
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OREGON EMPLOYMENT DEPARTMENT
Remote
Part-Time
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Job Description
Job Listing ID:
4498907Job Title:
Senior Fraud and Waste Investigator Application Deadline:
Open Until FilledJob Location:
SalemDate Posted:
05/26/2026Hours Worked Per Week:
Not Provided Shift:
Not Provided Duration of Job:
Either Full or Part Time, more than 6 months You may contact this employer directly. (Obtain the contact information to print or add to your jobs.)Job Summary:
Become a part of our caring community The Senior Fraud and Waste Investigator conducts investigations of allegations of fraudulent and abusive practices. Work assigned to the Senior Fraud and Waste Investigator involves moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Fraud and Waste Investigator conducts comprehensive investigations into allegations of fraud, misconduct, and other unethical or unlawful activity impacting the organization and its stakeholders. This role focuses on complex, non-traditional investigations, including agent misconduct, internal matters, and other high-risk issues affecting brand integrity and compliance. The Senior Investigator manages end-to-end investigations by gathering and analyzing information, conducting interviews, and synthesizing findings into clear, well-supported conclusions. All investigative activities are thoroughly documented in alignment with organizational and regulatory standards. This role identifies patterns and emerging risks, providing insights to support mitigation strategies and business decisions. The investigator collaborates with internal partners such as Legal, Human Resources, and Compliance, and may coordinate with external regulatory or law enforcement agencies as needed. The Senior Investigator exercises independent judgment in handling complex assignments, influencing investigative strategy, and recommending actions, while working with minimal direction and demonstrating leadership capability. Use your skills to make an impactWORK STYLE
Work at home, remote. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.WORK HOURS
Typical business hours are Monday-Friday, 8 hours/day, 5 days/week. All associates will align their work hours to EST, regardless of their home time zone. Required Qualifications Bachelor's degree At least 3 years of health insurance fraud investigations and other investigative/auditing experience Knowledge of healthcare payment methodologies Inquisitive nature with ability to analyze data to metrics High level of computer literacy (MS, Word, Excel, Access) Exceptional organizational, interpersonal, and communication skills Strong personal and professional ethics Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Graduate degree and/or certifications (MBA, J.D., MSN, Clinical Certifications, CPC, CCS, CFE, AHFI) Understanding of healthcare industry, claims processing and investigative process development Experience in a corporate environment and understanding of business operations Additional Information Work at Home Requirements- At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
- Satellite, cellular and microwave connection can be used only if approved by leadership
- Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
- Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
- Work from a dedicated space lacking ongoing interruptions to protect member