Workforce Classification: Telecommuter Join Our Team: Do Meaningful Work and Improve People’s Lives Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare. Premera is committed to being a workplace where people feel empowered to grow, innovate, and lead with purpose. By investing in our employees and fostering a culture of collaboration and continuous development, we’re able to better serve our customers. It’s this commitment that has earned us recognition as one of the best companies to work for. Learn more about our recent awards and recognitions as a greatest workplace. Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog: https://healthsource.premera.com/. As a member of Premera’s Special Investigations Unit (SIU), the Investigator III leads complex investigations into allegations of external fraud, waste, and abuse (FWA). This role manages medium to high complexity cases from initiation through resolution, producing thorough, well documented investigative reports that may be subject to legal discovery. The Investigator III conducts detailed analysis, collaborates closely with SIU colleagues, and balances multiple investigations simultaneously. In this role, you will also work to identify and recover improper payments resulting from fraudulent or misrepresentative billing, while ensuring all investigative activities comply with company policies, regulatory requirements, and applicable laws. As a not-for-profit organization, Premera offers the opportunity to do this work with a genuine focus on doing what’s right for our members—supported by leaders who believe in the impact this team makes, not just the metrics. What you’ll do: - Analyze healthcare claim data and vet referrals to detect fraudulent activity and independently determine the most effective and efficient method of investigation for each individual case. - Perform investigative field work to include on-site office visits, record collection, and surveillance. - Interview suspects and witnesses. - Prepare cases, testify and give depositions to law enforcement and regulatory agencies for potential criminal prosecution. - Participate in settlement negotiations with attorneys and other responsible parties. - Perform root cause analysis of identified issues and prepare post-investigative reports directed towards the prevention of fraud. - Make recommendations for creating SIU policies, procedures, workflows and process improvements. - Develop and maintain collaborative and liaison relationships with Blue Cross Blue Shield Association (BCBSA), Blue Cross Blue Shield (BCBS) Plans, HHS OIG, other carriers' anti-fraud professionals, law enforcement and regulatory agencies. - May attend webinars and conferences like BCBSA, National Health Care Anti-Fraud Association (NHCAA), and Association of Certified Fraud Examiners (ACFE) to keep apprised of developments in health care fraud. What you’ll bring: - Bachelor’s degree in business administration, health care administration, finance, accounting, nursing or criminal justice or (4) years of work experience in field of study. (Required) - (3) years of experience in fraud investigation, special investigation unit, or a related field. (Required) - Certified Professional Coder (CPC), Certified Fraud Examiner (CFE), or Accredited Health Care Fraud Investigator (AHFI). - Two (2) years of active experience in auditing and investigating in the healthcare industry. - Significant experience with relevant technology, such as background check systems, claims processing platforms, data mining, and fraud detection software. - Demonstrated knowledge of institutional and/or professional payment methodologies. - Strong understanding of health insurance reimbursement methodologies, including familiarity with International Classification of Diseases (ICD-10 CM), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS). - Strong computer aptitude and experience with spreadsheet and database software, e.g., Excel, Access, Focus. - Demonstrated strong technical writing skills - ability to write reports and business correspondence and to prepare case files. - Ability to exercise a very high level of discretion when handling sensitive information. Premera total rewards Our comprehensive total rewards package provides support, resources, and opportunities to help employees thrive and grow. Our total rewards are more than a collection of perks, they're a reflection of our commitment to your health and well-being. We offer a broad array of rewards including physical, financial, emotional, and community benefits, including: - Medical, vision, and dental coverage with low employee premiums. - Voluntary benefit offerings, including pet insurance for paw parents. - Life and disability insurance. - Retirement programs, including a 401K employer match and, believe it or not, a pension plan that is vested after 3 years of service. - Wellness incentives with a wide range of mental well-being resources for you and your dependents, including counseling services, stress management programs, and mindfulness programs, just to name a few. - Generous paid time off to reenergize. - Looking for continuing education? We have tuition assistance for both undergraduate and graduate degrees. - Employee recognition program to celebrate anniversaries, team accomplishments, and more. For our hybrid employees, our on-campus model provides flexibility to create your own routine with access to on-site resources, networking opportunities, and team engagement. - Commuter perks make your trip to work less impactful on the environment and your wallet. - Free convenient on-site parking. - Subsidized on-campus cafes make lunchtime connections with colleagues fun and affordable. - Participate in engaging on-site activities such as health and wellness events, coffee connects, disaster preparedness fairs and more. - Our complementary fitness & well-being center offers both in-person and virtual workouts and nutritional counseling. - Need a brain break? Challenge someone to a game of shuffleboard or ping pong while on campus. Equal employment opportunity/affirmative action: Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law. If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at careers@premera.com or via phone at 425-918-4785. Premera is hiring in the following states, with some limitations based on role or city: Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, Wisconsin. The pay for this role will vary based on a range of factors including, but not limited to, a candidate’s geographic location, market conditions, and specific skills and experience. The salary range for this role is posted below; we generally target up to and around the midpoint of the range. National Salary Range: $80,200.00 - $103,700.00 National Plus Salary Range: $80,200.00 - $118,300.00 *National Plus salary range is used in higher cost of labor markets including Western Washington and Alaska. We’re happy to discuss compensation further during the interview because we believe that open communication leads to better outcomes for all. We’re committed to creating an environment where all employees are celebrated for their unique skills and contributions.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Philadelphia Gun Violence Task Force investigates and prosecutes firearms trafficking, the straw purchase of firearms, the movement of illegal guns, and violent gun crime. This position involves working with the criminal investigative bureaus of the Office of Attorney General (OAG). An employee in this position is responsible for: - Performing duties which include the receipt, analysis, verification, and dissemination of information of a confidential and sensitive nature. - Providing information to the Attorney General, agents, management personnel of the OAG, the Pennsylvania legislature, other law enforcement and private sector agencies, and the general public. - Becoming familiar with the criminal threat to Pennsylvania and the northeastern and mid-Atlantic regions, as well as the US. - Obtaining a comprehensive understanding of the criminal threat environment and providing analytical insight, advice, and counsel to OAG decision-makers, attorneys, agents, and analysts. - Using appropriate software applications, including eTrace, and databases in the preparation of tactical, operational, and strategic analytical products. - Preparing comprehensive tactical, operational, and strategic assessments including written reports, oral presentations, visual illustrations, and charts. - Reading and researching publications on various criminal elements to develop and maintain a useful reservoir of knowledge of general patterns, trends, and scopes of crime. - Complying with all requirements of the Criminal History Records Information Act (CHRIA) and 28 C.F.R. Qualifications - Investigative Analyst I: A Bachelor’s Degree from an accredited college or university in Intelligence Analysis Studies, Criminology, Criminal Justice, or a related course of study OR four years of relevant experience, knowledge, and skill. - Investigative Analyst II: A Bachelor’s Degree from an accredited institution in Intelligence Analysis Studies, Criminology, Criminal Justice, or a related field of study and two years of relevant experience OR a Master’s Degree from an accredited institution in a related field OR six years of relevant experience. Requirements - Monitors and analyzes Bureau of Alcohol, Tobacco & Firearms eTrace crime gun data to develop leads and analyze trends in Pennsylvania gun trafficking. - Provides accurate, timely, predictive analysis to OAG leadership to deter, detect, and/or prevent credible criminal threats to the Commonwealth. - Provides investigative support to agents through the collection and analysis of information from various databases. - Provides pre-operational planning assistance to assist agents with warrant executions. - Monitors daily open source and sensitive information systems to obtain near real-time crime gun information. - Accurately identifies and effectively communicates information collection requirements. - Provides assistance to law enforcement staff by compiling data from various sources. - Produces a spectrum of gun-related intelligence products for use by OAG leadership and operations personnel. - Uses electronic data processing systems to research, analyze, and store data. - Writes reports of analysis and/or investigative findings for use in investigations, criminal complaints, and search and arrest warrants. - Testifies in court proceedings and grand jury proceedings regarding analytical findings. - Presents analytical briefings, case studies, and presentations on behalf of the OAG at conferences, seminars, and trainings. - Performs other duties as assigned. Benefits - Investigative Analyst I: Starting salary of $45,907 - Investigative Analyst II: Starting salary of $59,345

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This role involves assessing risks and vulnerabilities related to proprietary data and security systems. - Participate in conduct of controls and security assessments to assess risk of exposure of proprietary data - Provides technical support on post event network security logs and trend analysis - Uncovers security and compliance violations - Associates and correlates IP address related events with specific systems or devices in the IT infrastructure - Support development and analysis of system and security documentation - Maintain documentation for exceptions to standards Qualifications - U.S. Citizenship Mandatory - Required Clearance: Public Trust Requirements - Experience in risk assessment and security analysis - Technical knowledge of network security and compliance Benefits - Comprehensive benefits package - Competitive pay

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Responsible for support, maintenance and development of tools utilized to generate cyber security events and incidents across the company environment. - Work closely with peers, other internal/external teams and management in a 24x7 Cybersecurity Operations Center (CSOC) environment. - Follow processes and procedures as defined by Cybersecurity leadership and the Computer Incident Response Team (CIRT). - Monitor security alerts and events generated across the environment. - Perform daily investigation and triage of potential threats. - Correlate activity across multiple security tools to identify malicious behavior or suspicious activity. Qualifications - Bachelor’s Degree in Cybersecurity, Computer Science, or other degrees with a high level understanding of network and application security and information systems, or equivalent experience. - 5–9 years of experience. Requirements - Experience in maintaining and facilitating the cyber incident response procedure. - Technology savvy with experience in key Microsoft Office products. - Strong verbal and written communications skills. - Experience with managing small projects, keeping organized plans/trackers, and working in a technical environment. - Experience with developer and/or automation tools is also a desired skillset. Company Description