Senior Anti-Fraud Investigator & Team Lead

Summary

Highmark Inc. is seeking an experienced investigator to develop and maintain an anti-fraud program, conduct investigations into fraud, waste and abuse, and coordinate with law enforcement.The role includes training, case referrals, and field work across providers, members, facilities, pharmacies, and departments. The incumbent will testify in court, compile cases for referrals, and lead audits to comply with internal and regulatory requirements, including OFAC checks and annual fraud plan#J-18808-Ljbffr

Job Description

Highmark Inc. is seeking an experienced investigator to develop and maintain an anti-fraud program, conduct investigations into fraud, waste and abuse, and coordinate with law enforcement.The role includes training, case referrals, and field work across providers, members, facilities, pharmacies, and departments. The incumbent will testify in court, compile cases for referrals, and lead audits to comply with internal and regulatory requirements, including OFAC checks and annual fraud plan#J-18808-Ljbffr