Pharmacy Investigator Senior

Job description

Anticipated End Date: 2026-05-18 Position Title: Pharmacy Investigator Senior Job Description: Pharmacy Investigator Senior Location(s) : 21215 Burbank Blvd, Woodland Hills, CA, 3080 Bristol St, Costa Mesa, CA and 2121 N. California Blvd, Walnut Creek, CA Hybrid : This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Pharmacy Investigator Senior is responsible for the independent identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent claims. How you will make an impact: Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use of propriet...