Senior Fraud and Waste Investigator

Become a Part of Our Caring Community and Help Us Put Health First

The Senior Fraud and Waste Professional conducts investigations of allegations of fraudulent and abusive practices. The Senior Fraud and Waste Professional work assignments involve 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 Professional coordinates investigation with law enforcement authorities. Assembles evidence and documentation to support successful adjudication, where appropriate. Conducts on-site audits of provider records ensuring appropriateness of billing practices. Prepares complex investigative and audit reports. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

This role is REMOTE, WORK AT HOME (anywhere in the US). While this is a remote position, up to 15% (local, regional, national) travel will be required, plus occasional travel to Humana's offices for training or meetings may be required. Typical business hours are Monday-Friday, 8 hours / day, 5 days / week.

Required Qualifications

• Bachelor's degree
• At least 5 years of fraud investigations, corporate investigations, and / or auditing experience
• Strong organizational, interpersonal, and communication skills
• Inquisitive nature with ability to analyze data to metrics
• Advanced computer skills / literacy (MS Word, Excel, Access, Power Point, Power BI)
• Strong personal and professional ethics
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• Up to 15% (local, regional, national) travel will be required

Preferred Qualifications

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline : 11-20-2025

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. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements.