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Dental Fraud Abuse Jobs (NOW HIRING)

CVS Health

Product Manager, Fraud & Abuse

$92K - $203K/yr

As a Product Manager for Fraud & Abuse, you will lead the ongoing development and expansion of key ... The benefits for this position include medical, dental, and vision coverage, paid time off ...

Extend

Fraud Operations Specialist I

$50K - $63K/yr

This role requires direct experience with fraud and abuse operations (preferably in an eCommerce ... Competitive salary based on experience, with full medical and dental & vision benefits. * Stock in ...

OUCU

Account Fraud Manager

East Lansing, MI · Hybrid

$90K - $110K/yr

... fraud, abuse and compliance violations. Work Location - This position is a hybrid working ... Dental, Vision, Life, and Long-Term Disability Premiums * Up to 26 days of PTO within your first ...

Target

Senior Fraud Intelligence Analyst

Minneapolis, MN · Hybrid

$88K - $158K/yr

... dental, life insurance and more, to help you and your family take care of your whole selves.Other ... You will work closely across the Fraud & Abuse space with fellow analysts, investigators, and ...

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Dental Fraud Abuse information

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$15

$30

$53

How much do dental fraud abuse jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for dental fraud abuse in the United States is $30.83, according to ZipRecruiter salary data. Most workers in this role earn between $22.12 and $35.34 per hour, depending on experience, location, and employer.

What is dental fraud and abuse?

Dental fraud and abuse refer to illegal or unethical actions by dental professionals, patients, or others to obtain unauthorized benefits from dental insurance programs. This can include billing for services not provided, misrepresenting procedures, or performing unnecessary treatments. Detecting and preventing dental fraud is important to protect patients and ensure the integrity of dental care. Insurance companies and regulatory agencies use audits and investigations to identify and address potential cases of fraud and abuse.

What are the key skills and qualifications needed to thrive as a dental fraud investigator?

To thrive as a Dental Fraud Investigator, you need a solid understanding of dental billing practices, healthcare regulations, and investigative techniques, often supported by a background in dental hygiene, healthcare administration, or criminal justice. Familiarity with claims management systems, data analysis tools, and relevant certifications such as Certified Professional Coder (CPC) or Certified Fraud Examiner (CFE) is typically required. Strong attention to detail, analytical thinking, and effective communication are vital soft skills for uncovering discrepancies and reporting findings. These competencies are essential for accurately identifying fraud or abuse, protecting patient interests, and ensuring the integrity of dental healthcare systems.

What are some typical challenges faced by professionals working in dental fraud and abuse prevention roles?

Professionals in dental fraud and abuse prevention roles often face challenges such as staying updated with evolving regulatory requirements and identifying increasingly sophisticated fraudulent schemes. They must carefully review large volumes of claims data for inconsistencies while balancing the need for thoroughness with efficiency. Collaboration with dental practitioners, insurance providers, and legal experts is common to ensure investigations are comprehensive and compliant with industry standards. Keeping up with new detection technologies and maintaining confidentiality throughout the investigative process are also key aspects of the role.

What is the difference between Dental Fraud Abuse vs Dental Office Administrator?

AspectDental Fraud AbuseDental Office Administrator
Required credentialsKnowledge of billing, coding, legal regulationsAdministrative skills, office management
Work environmentLegal, compliance, billing departmentsFront desk, scheduling, patient management
Employer & industry usageDental practices, insurance companies, legal agenciesDental offices, clinics, healthcare facilities
Search & comparison intentUnderstanding fraud detection, legal issuesManaging dental office operations

Dental Fraud Abuse involves identifying and preventing fraudulent billing and illegal activities within dental practices, often requiring knowledge of legal and billing procedures. In contrast, a Dental Office Administrator manages daily office operations, patient scheduling, and administrative tasks. While both roles are essential in dental settings, they focus on different aspects—compliance and legal issues versus administrative management.

More about Dental Fraud Abuse jobs

What cities are hiring for Dental Fraud Abuse jobs?

Cities with the most Dental Fraud Abuse job openings:

What states have the most Dental Fraud Abuse jobs?

States with the most job openings for Dental Fraud Abuse jobs include:

What job categories do people searching Dental Fraud Abuse jobs look for?

The top searched job categories for Dental Fraud Abuse jobs are:

Dental Fraud Abuse jobs near you
Infographic showing various Dental Fraud Abuse job openings in the United States as of August 2026, with employment types broken down into 75% Full Time, and 25% Part Time. Highlights an 75% In-person, and 25% Remote job distribution, with an average salary of $64,132 per year, or $30.8 per hour.

Product Manager, Fraud & Abuse

CVS Health

Remote

$92K - $203K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 24 days ago

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,369 frontline employees who took The Breakroom Quiz

92nd of 113 rated pharmacies

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 ourselvesaccountable 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.

As a Product Manager for Fraud & Abuse, you will lead the ongoing development and expansion of key Fraud, Waste, and Abuse (FWA) products that deliver over $200M in annual impact. In this role, you will directly support CVS Health's Payment Optimization Analytics objectives, contributing to the achievement of revenue and ROI targets for analytics products. You will be responsible for monitoring product performance, driving enhancements, and overseeing the deployment and scaling of advanced FWA analytics capabilities.

Key Duties will be:

  • Own the product vision, strategy, and performance, ensuring delivery of measurable business value and alignment with organizational goals

  • Identify and prioritize opportunities to integrate AI/ML capabilities into products to enhance accuracy, efficiency, and scalability

  • Translate market trends, user feedback, and competitive intelligence into actionable product direction, monitoring shifts to identify emerging opportunities and risks

  • Lead a cross-functional squad of data engineers, data scientists, and ideation team members, managing competing priorities and perspectives to keep the squad focused and moving forward

  • Define and document the "what" and "why" for the squad, including setting the problem, shaping priorities, and making tradeoffs clear

  • Develop and maintain core product artifacts including roadmap, backlog, sprint plans, and demo materials

  • Facilitate key forums including stakeholder sessions, sprint planning, working sessions, and product demos

  • Continuously evaluate advancements in AI/ML and assess applicability to enhance the product portfolio

  • Establish and monitor KPIs related to product performance, adoption, and business impact

  • Develop compelling, data-driven business cases for new product capabilities and enhancements, securing stakeholder alignment and financial investments to support strategic priorities

  • Ensure high-quality, timely delivery of product enhancements that meet defined business and technical requirements


Required Qualifications

  • 3+ years of experience in product management or product ownership

  • 3+ years of experience within the healthcare industry

  • Demonstrated experience managing product roadmaps and defining product requirements

  • Proven ability to influence and collaborate effectively across cross-functional teams and senior stakeholders

  • Ability to operate in ambiguity, translating evolving business objectives into clear, prioritized initiatives

  • Experience leveraging AI/ML technologies to drive measurable business value

  • Ability to analyze complex data and translate insights into actionable product strategy and business decisions

Preferred Qualifications

  • Experience in Payment Integrity, with a focus on Fraud, Waste, & Abuse (FWA)

  • Strong financial acumen, with the ability to assess business impact and drive value-based decisions

  • Experience working within Agile product management frameworks and methodologies

  • Working knowledge of healthcare claims processing, including end-to-end claims lifecycle

Education

  • Bachelor's degree or equivalent work experience with healthcare, claims processing, or vendor management

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$92,700.00 - $203,940.00

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 fulltime position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial wellbeing 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: 10/30/2026

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

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