Back to the board

Analyst, Special Investigative Unit

100% remote Flexible hours Hiring now

Are you a highly motivated and detail-oriented individual with a passion for uncovering fraudulent activities? Do you thrive in a fast-paced environment, where you can use your analytical skills to make a difference? Aetna is seeking a dedicated and experienced Analyst to join our Special Investigative Unit (SIU). As an Analyst, you will play a crucial role in detecting and preventing fraudulent behavior within our organization. This is a unique opportunity to join a dynamic team and contribute to the overall success of Aetna. If you have a strong investigative mindset and meet the qualifications listed below, we encourage you to apply and be a part of our mission to provide quality healthcare to our members. Conduct thorough and detailed investigations into potential fraudulent activities within the organization. Utilize analytical skills and tools to identify patterns and trends in data that may indicate fraudulent behavior. Collaborate with other team members to gather and analyze information from multiple sources. Prepare and present reports and findings to management and relevant stakeholders. Develop and maintain strong relationships with internal departments and external partners to share information and coordinate efforts. Stay up-to-date on industry trends and best practices for fraud detection and prevention. Follow established protocols and procedures for handling and documenting investigations. Identify potential areas of vulnerability and make recommendations for process improvements to mitigate fraud risk. Maintain confidentiality and handle sensitive information with discretion. Communicate findings and recommendations to management and assist in implementing necessary changes. Participate in training and development opportunities to enhance investigative skills and knowledge. Adhere to all legal and regulatory requirements related to fraud detection and prevention. Collaborate with law enforcement and other external entities as needed. Represent the organization in a professional and ethical manner at all times. Work independently and efficiently to meet deadlines and achieve goals set by management. Aetna is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Apply To This Job

Keep exploring

[Hiring] QA Examiner/File Review Positions @RYZE Claim Solutions

100% remote Flexible hours

Immediate Start Easy Remote Data Entry For Teens From Home Entry

100% remote Flexible hours

Work-From-Home Sales & Customer Support for Major Cruise Line

100% remote Flexible hours

Claims Examiner, Casualty

100% remote Flexible hours

Contact Center MSR II - Remote - Sacramento, CA only

100% remote Flexible hours

Student - Advanced Web Developer/Programmer

100% remote Flexible hours

Experience Designer, Offline Design

100% remote Flexible hours

RN - Stem Cell Transplant (F7)

100% remote Flexible hours

SIU Program Integrity Investigator - Remote (In Idaho)

100% remote Flexible hours

Sr. Technical Product Owner – SAP Order to Cash & Commerce Cloud – Strategy & Ma

100% remote Flexible hours

Experienced Data Entry Specialist – Remote Opportunity at arenaflex

100% remote Flexible hours

Customer Support Agent (Remote, English Speaking, starting May 18th)

100% remote Flexible hours

Research and Development Scientist III, Algorithm Developer

100% remote Flexible hours

Remote Fitness Program Developer

100% remote Flexible hours

Software Engineer, Data Infrastructure & Acquisition - Da Nang, Vietnam

100% remote Flexible hours

Territory Sales officer

100% remote Flexible hours

Amazon PPC Specialist – Customized/Personalized Product Listings

100% remote Flexible hours

Account Coordinator, Brand

100% remote Flexible hours

Experienced Data Entry Operator – Remote Full Time / Part Time Opportunity at arenaflex

100% remote Flexible hours

Senior DevOps Engineer - Remote

100% remote Flexible hours