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Pharmacy Fraud Investigator-Remote

Remote, USA Full-time Posted 2025-11-24
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 To this Job

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