Become a part of our caring community and help us put health first

The Fraud and Waste Professional 2 is your go-to investigator for digging deep into potential healthcare fraud, waste, and abuse. This isn't your typical desk job — you'll be tackling varied assignments that demand sharp critical thinking and the ability to make nuanced judgment calls. You'll work across multiple departments, connecting the dots to identify sneaky patterns and analyze claims that might signal something's not quite right. Your mission? Ensure everything is above board, contracts are interpreted correctly, and all policies are followed to the letter. Think of yourself as a healthcare compliance detective. Your key responsibilities include gathering rock-solid evidence, preparing complex investigative reports that tell a compelling story, and presenting recommendations that can influence senior leadership. You'll be auditing provider records, verifying billing practices, and making sure everything aligns with state and federal regulations. This role requires someone who can navigate organizational strategy like a pro, make independent decisions (even when things get murky), and operate with minimal supervision while staying true to established guidelines.

Use your skills to make an impact

Required Qualifications • Registered and/or Pharmacy Technician Certification plus 3+ years in retail, specialty, or mail order pharmacy (or equivalent FWA investigation experience) • Minimum 3 years investigating pharmacy and/or medical fraud, waste, and abuse • Deep knowledge of healthcare industry mechanics, claims processing, and payment systems • Killer organizational and communication skills • Ability to self-manage, prioritize cases, and work independently • Extensive investigative procedure expertise • Sharp analytical skills for creating and interpreting complex metrics • Microsoft Office wizard (especially Excel) • Ironclad personal and professional ethics • Willing to travel up to 15% of the time Preferred Qualifications • CFE and/or AHFI Certifications • Bachelor's degree and/or additional professional certifications • Experience developing investigative processes and crafting policies • Power BI visualization skills for data analysis and reporting Travel: Remote position with occasional in-person training or meetings. Scheduled Weekly Hours: 40 Pay Range: $65,000 - $88,600 per year (with bonus incentive potential) This job offers competitive benefits supporting whole-person wellness, including medical, dental, vision, 401(k), generous time off, and much more. Application Deadline: 07-22-2025

About us

About CenterWell Pharmacy: We're all about convenient, safe, reliable pharmacy services. Whether through home delivery, over-the-counter fulfillment, specialty, or retail locations, we provide integrated solutions that make healthcare simpler. About CenterWell, a Humana company: We put patients at the center of everything. As the nation's largest senior-focused primary care provider, we're committed to whole-person health — physical, emotional, and social wellness. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status.