Top 114 Senior case Jobs in Montana

Senior Investigator, Special Investigations Unit (Aetna SIU)
CVS Health —Montana
- $46,988 - $112,200 a year
- Full-time
- Remote
- Mid-level
- 3 years
- Analysis skills
- Health insurance
- Dental insurance
Barista - PT
Barnes & Noble, Inc. —Billings, MT
- Part-time
- Serving
- Entry level
- Paid parental leave
- Paid holidays
Corporate Strategy Consulting Associate
CSAA Insurance Services, Inc. —Montana
- $129,825 - $173,150 a year
- Full-time
- Remote
- Microsoft Excel
- Mid-level
- High school diploma or GED
- 401(k) matching
2d
Compliance Examiner
D.A. Davidson —Great Falls, MT
- $54,486 - $80,000 a year
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Paid holidays
- Health insurance
4d
Senior Manager, Mental Well-being Operations Innovation
CVS Health —Montana
- $67,900 - $199,144 a year
- Full-time
- Remote
- 7 years
- SQL
- Analysis skills
- Health insurance
- Dental insurance
3d
Litigation Resource Team Manager
Earthjustice —Bozeman, MT
- $101,700 - $125,500 a year
- Email
- Hybrid work
- 5 years
- Bachelor's degree
- Mentoring
Quality Assurance Analyst
AdvicePay —Bozeman, MT
- $84,405 - $92,846 a year
- Full-time
- Hybrid work
- Mid-level
- SQL
- Analysis skills
- Paid parental leave
- AD&D insurance
Senior Business Analyst - Meritain Health
CVS Health —Helena, MT
- $46,988 - $122,400 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Health insurance
- Dental insurance
1d
Adult Protective Services Investigator
State of Montana —Montana
- $31.55 an hour
- Online Application
- Up to 50% travel
- Experience working with individuals with disabilities
- Writing skills
- Paid holidays
- Health insurance
10d
Director, Transaction Management
Cushman & Wakefield —Whitefish, MT
- $157,250 - $185,000 a year
- Full-time
- Microsoft Word
- Microsoft Outlook
- Real Estate License
- Health savings account
- Disability insurance
Quick Apply
Brain Injury Program Specialist
State of Montana —Montana
- $34.09 an hour
- Full-time
- Public speaking
- Mid-level
- Bachelor's degree
- Paid holidays
- Health insurance
Senior Pega Developer
ATTAINX INC —Helena, MT
- $130,000 - $139,000 a year
- Full-time
- Remote
- Computer Science
- 5 years
- SQL
- Disability insurance
- Health insurance
Program Manager
The Building People —Billings, MT
- $110,000 - $125,000 a year
- Full-time
- Background check
- Analysis skills
- Bachelor's degree
- AD&D insurance
- Paid holidays
Quick Apply
District Service Quality Manager (PDX-D4-Missoula)
Subaru of America —Missoula, MT
- $94,800 - $115,000 a year
- Full-time
- Microsoft Excel
- 6 years
- Microsoft Outlook
- Profit sharing
- Health insurance
Discharge Planner
Rimrock Foundation —Billings, MT
- Clean driving record
- Microsoft Excel
- Microsoft Outlook
Quick Apply
Senior Performance Engineer
ACCURE Battery Intelligence GmbH —Bozeman, MT
- Remote
- English
- Senior level
- Communication skills
- Paid time off
- Flexible schedule
Quick Apply
Executive Assistant & Scheduler
State of Montana —Helena, MT
- $26.02 an hour
- Online Application
- Mid-level
- Office
- High school diploma or GED
- Paid holidays
- Health insurance
11d
Senior Social Worker - ICMHR Case Manager
US Veterans Health Administration —Fort Harrison, MT
- $93,537 - $121,601 a year
- Online Application
- Hybrid work
- Background check
- Master of Social Work
- Current TB test
- Paid parental leave
- Paid holidays
1d
Senior Exec. Assistant & Scheduler
State of Montana —Helena, MT
- $28.36 an hour
- Online Application
- Office
- High school diploma or GED
- Travel
- Paid holidays
- Health insurance
11d
Compliance & Operations Coordinator
D.A. Davidson —Great Falls, MT
- Overtime
- Mid-level
- High school diploma or GED
- Analysis skills
- Paid holidays
- Health insurance
1d

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senior case jobs near montana

Senior Investigator, Special Investigations Unit (Aetna SIU)

CVS Health -
Montana

Apply Now

Job Details

Full-time
$46,988 - $112,200 a year

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

Healthcare financial misconduct investigations
Data visualization software proficiency
Suspicious activity investigations
Investigative data analysis
HCPCS
Business intelligence tools
Insurance investigations
Productivity software

Full Job Description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

The Senior Investigator, Aetna Special Investigations Unit, will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse. This position will routinely handle high profile or highly sensitive matters involving cases that are national in scope, as well as, complex cases involving multi-lines of business, multiple subjects, or intricate healthcare fraud schemes.

Investigate matters of program integrity to prevent payment of aberrant claims submitted to the Medicaid lines of business for payment
Conduct thorough research on subject(s) and related entities
Initiate independently proactive data mining using SIU Tools to identify aberrant billing patterns and early scheme detection
Conduct extensive analysis of claims data to determine aberrancy, pattern, or scheme
Research and prepare cases for both clinical and legal review
Collaborate with Medical Directors on clinical issues and medical record questions
Accurately documents all case activity and communications in designated case tracking system
Communicate clinical findings to provider
Adherence to all regulatory requirements
Facilitate case outcomes for the recovery of company and customer monies lost from aberrant billing
Provide training and guidance to new and junior investigators
Assist junior Investigators in identifying resources for cases; offer suggestions on investigative strategy
Serve as back up to the Team Leader as necessary
Collaborate with federal, state, and local law enforcement agencies for the investigation and prosecution of healthcare fraud issues
Communicate clearly a high level of FWA knowledge and understanding during interactions with both internal and external stakeholders
Experience in witness testimony; Proficient in testifying for both civil and criminal proceedings
Strong communication skills, both written and oral, are necessary for the development and implementation of professional presentations for internal and external stakeholders regarding healthcare fraud matters and Enterprise approach to FWA
Communicate ideas on efficiency gains; provides input regarding controls for monitoring FWA among the business segments

Required Qualifications

3+ years investigative experience in healthcare fraud and abuse matters
Working knowledge of medical coding; CPT, HCPCS, ICD10
Proficient in Microsoft Office with advanced skills in Excel (pivot tables are a must, Power BI, etc.)
Strong analytical ability to view and slice claims data in multiple facets
Self-starter: initiates research that will be vital to an investigation
Proficient in researching information and identifying new resources helpful to all cases
Ability to travel up to 10%

Preferred Qualifications

5+ years investigative experience in healthcare fraud and abuse matters
Medicaid/Medicare investigation experience; knowledge of applicable rules and regulations
Exercises independent judgement; uses available resources and technology in developing evidence, supporting allegations for fraud and abuse
Credentials: Association of Certified Fraud Examiners (CFE) or National Health Care Anti-Fraud Association (AHFI)
Knowledge and understanding of complex clinical issues
Customer-Focused. Ability to effectively interact and collaborate with various stakeholders and departments to drive solution
Strong verbal and written communication skills (using correct grammar, spelling, sentence structure, etc.)

Education

Bachelor's degree or equivalent experience (5+ of working health care fraud, waste and abuse investigations)

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$46,988.00 - $112,200.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 08/22/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Apply Now

Refine Your Search

senior case jobs in montana

Senior Investigator, Special Investigations Unit (Aetna SIU)

Barista - PT

Corporate Strategy Consulting Associate

Compliance Examiner

Senior Manager, Mental Well-being Operations Innovation

Litigation Resource Team Manager

Quality Assurance Analyst

Senior Business Analyst - Meritain Health

Adult Protective Services Investigator

Director, Transaction Management

Brain Injury Program Specialist

Senior Pega Developer

Program Manager

District Service Quality Manager (PDX-D4-Missoula)

Discharge Planner

Senior Performance Engineer

Executive Assistant & Scheduler

Senior Social Worker - ICMHR Case Manager

Senior Exec. Assistant & Scheduler

Compliance & Operations Coordinator

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