Fraud Advisor

Cigna Healthcare • St. Louis, MO

3d • Remote

About The Position

The Fraud Advisor supports the identification, development, and resolution of fraud, waste, and abuse (FWA) investigations across the healthcare environment. This role applies investigative judgment, data analysis, and collaboration with cross‑functional partners to assess risk, document findings, and support program integrity efforts.

Requirements

• If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Responsibilities

• Apply advanced professional knowledge to effectively manage complex fraud, waste, and abuse concerns involving prescriber and pharmacy activity on behalf of client needs and expectations, independently and with minimal management oversight.
• Identify and recommend solutions to improve SIU workflows and address operational weaknesses through process improvement initiatives.
• Assist with training, case staffing, and End2End review support for new and seasoned investigators on an ongoing basis.
• Work independently and collaboratively with internal and external business partners to oversee and execute projects and requests responsive to client needs.
• Collaborate with fraud leadership and cross‑functional partners to identify trends, mitigate emerging risks, and enhance enterprise fraud prevention strategies.

Benefits

• Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
• We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed