• Investigator, Special Investigative Unit…

    Molina Healthcare (Owensboro, KY)
    …opinions. + Knowledge of investigative and law enforcement procedures with emphasis on fraud investigations . + Knowledge of Managed Care and the Medicaid and ... Healthcare Services, Member Services, Claims) to gather documentation pertinent to investigations . + Detects potential health care fraud , waste, and… more
    Molina Healthcare (07/24/25)
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  • SIU Specialist - Pharmacy Tech - Remote in…

    Prime Therapeutics (Frankfort, KY)
    …& Experience** + Education Level Bachelors + Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the ... for work visa or residency sponsorship. **Additional Qualifications** + 3+ years' fraud investigations /claims experience. + Ability to manage workload while… more
    Prime Therapeutics (06/24/25)
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  • Special Investigations Unit (SIU)…

    Allied Universal (Louisville, KY)
    …(5) years of demonstrated professional law enforcement experience with specific attention to investigations related to fraud + Ability to be properly licensed as ... and Paid Holidays (FT only)** Allied Universal(R) is hiring a Special Investigations Unit (SIU) Investigator. Special Investigations Unit (SIU) Specialists… more
    Allied Universal (07/30/25)
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  • Manager, Special Investigation

    CVS Health (Frankfort, KY)
    …Medicaid experience is preferred. Leads a team in the planning and execution of investigations of acts of healthcare fraud and abuse by both members and ... **Required Qualifications** + 2 to 5 years of managing healthcare fraud , waste and abuse investigations and audits. + 3 to 5 years of leadership experience… more
    CVS Health (08/01/25)
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  • Director, Compliance ((Must reside…

    Molina Healthcare (KY)
    …SIU an active relationship with third parties who have specific experience in conducting fraud and abuse investigations . * Prepares written reports to inform the ... accountability for compliance by overseeing, follow-up and resolution of investigations . **Knowledge/Skills/Abilities** * Responsible for oversight and management of… more
    Molina Healthcare (07/12/25)
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  • Director, Protection Services Operations Center…

    Molina Healthcare (KY)
    …(PSOC) Team. Responsible for the monitoring and intelligence, incident response, and investigations programs which are in place to avoid business disruption, threats ... as possible. **Job Duties** + Responsible for operational physical security, investigations , and incident response for the enterprise to proactively monitor,… more
    Molina Healthcare (06/29/25)
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  • Surveillance Investigator -Experienced

    Command Investigations (Louisville, KY)
    Command Investigations LLC is a dynamic and forward-thinking investigative company that has been at the forefront of the industry since its establishment in ... as a leader in the investigation industry. At Command Investigations , we take pride in our proven track record...+ Minimum of 1 year experience relating to Work Compensation/ Fraud /Mobile and Stationary surveillance + Be able to hold… more
    Command Investigations (05/23/25)
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  • Manager, Special Investigative Unit-Kentucky

    Molina Healthcare (Covington, KY)
    …accountability for compliance by overseeing, follow-up and resolution of investigations . **KNOWLEDGE/SKILLS/ABILITIES** + Provides oversight and review of the SIU ... + Works with leadership to maintain and revise policies and procedures, fraud , waste, and abuse plans, annual audit work plans, including department guidance… more
    Molina Healthcare (07/18/25)
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  • Associate Director, MSAT, Upstream

    Otsuka America Pharmaceutical Inc. (Frankfort, KY)
    …manufacturing operations at CDMOs, including review of batch records, deviation investigations , and change controls. + Lead or significantly contribute to ... troubleshooting efforts and root cause investigations for upstream process deviations or performance issues at CDMOs. + Analyze upstream process data (via CPV… more
    Otsuka America Pharmaceutical Inc. (07/18/25)
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  • Associate Director, MSAT, Downstream Drug…

    Otsuka America Pharmaceutical Inc. (Frankfort, KY)
    …manufacturing operations at CDMOs, including review of batch records, deviation investigations , and change controls. + Lead or significantly contribute to ... troubleshooting efforts and root cause investigations for downstream process deviations or performance issues at CDMOs. + Analyze downstream process data (via CPV… more
    Otsuka America Pharmaceutical Inc. (07/18/25)
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