Hiring: Investigator II Company: Point32Health Location: Canton, MA Job Posted Time: 2026-09-10 13:21:24 Employment Type: Contract About the job Experience: •Required (minimum): 3-5 years’ related experience in health insurance and/or fraud investigations. •Preferred: Experience in audits/investigations including experience drafting and distributing summary findings notices to providers or other entities. Required Skills: •Lead moderately complex to complex investigations in established and emerging areas of Fraud Waste and Abuse (FWA) involving internal and external research, detailed data analyses, review of medical records, and interviews of members, providers, and other third parties. •Complete detailed reports of investigative activity and prepare summary findings notices for providers or other entities. •Interface directly with SIU management to educate providers, recover overpayments, take action to prevent future loss, and monitor provider activity post-investigation. •Identify root causes of fraud, waste and abuse and recommending internal and external corrective actions to address these root causes. •Develop new investigations based upon case findings. •Recommend investigative priorities, strategies, and techniques. •Interface directly with the analytics and intake team to develop and refine data mining to address new and evolving schemes. •Share expertise and promote investigative best practices among SIU management and staff. Qualifications: •Required (minimum): Bachelor’s degree •Preferred: Degree preferably in a clinical or scientific field, business, accounting, computer science, or criminal justice. •Demonstrated capacity to produce clear, concise, and well-organized documents. •Must be able to work under normal office conditions and work from home as required. •May be required to attend meetings at other company locations or other external meetings. •Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations. •May be required to work additional hours beyond standard work schedule. Compensation: •$80,990 - $121,486 / year Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!