• Manager, Fraud and Waste

    Humana (Springfield, IL)
    …- What it takes to Succeed** + Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with ... part of our caring community and help us put health first** The Special Investigations Unit Manager...of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste works within specific guidelines and procedures;… more
    Humana (08/09/25)
    - Related Jobs
  • SIU Field Investigator

    Travelers Insurance Company (Downers Grove, IL)
    …in or near the Chicago, IL area **What Will You Do?** + Conducts insurance investigations including applicable data base searches with a focus on uncovering ... and local office expectations. + Identifies cases for potential insurance fraud prosecution and submits questionable claims...experience required. **What Is in It for You?** + ** Health Insurance ** : Employees and their eligible… more
    Travelers Insurance Company (07/08/25)
    - Related Jobs
  • SIU Specialist - Pharmacy Tech - Remote in…

    Prime Therapeutics (Springfield, IL)
    …& 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)
    - Related Jobs
  • Clinical Provider Auditor II

    Elevance Health (Chicago, IL)
    …by law._ Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to ... and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an impact:**...new healthcare related questions as necessary to aid in investigations and stays abreast of current medical coding and… more
    Elevance Health (08/08/25)
    - Related Jobs
  • Senior Risk Partner - Compliance Officer

    Highmark Health (Springfield, IL)
    …all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the ... Program including auditing/monitoring operational processes, conducting or overseeing compliance investigations , and ensuring that adequate training takes place under… more
    Highmark Health (07/29/25)
    - Related Jobs
  • Surveillance Investigator - Experienced

    Command Investigations (Chicago, IL)
    insurance , PTO, 401(k) + Performance incentives + Biweekly pay Benefits: + 401(k) + Dental insurance + Health insurance + Vision insurance + Life ... Command Investigations LLC is a dynamic and forward-thinking investigative...+ Minimum of 1 year experience relating to Work Compensation/ Fraud /Mobile and Stationary surveillance + Be able to hold… more
    Command Investigations (06/16/25)
    - Related Jobs
  • Sr. Environmental, Health , and Safety…

    Jabil (Gurnee, IL)
    …vibrant and diverse communities around the globe. JOB SUMMARY: The Sr. Environmental, Health , and Safety (EHS) Engineer will establish and promote the maintenance of ... company personnel in compliance with local, state, regional, and national safety and health rules and regulations. + Consults with all departments on design and use… more
    Jabil (06/14/25)
    - Related Jobs
  • Senior Associate General Counsel

    Option Care Health (Bannockburn, IL)
    …-Flexible Spending Accounts -Tuition Reimbursement -myFlexPay -Family Support -Mental Health Services -Company Paid Life Insurance -Award/Recognition Programs ... limit to the growth of your career.** Option Care Health , Inc. is the largest independent home and alternate...relevant businesses. Assist with the oversight of the company's fraud , waste and abuse and self-referral compliance programs, HIPAA… more
    Option Care Health (07/31/25)
    - Related Jobs
  • Senior Director, MSAT Biologics

    Otsuka America Pharmaceutical Inc. (Springfield, IL)
    …process performance, troubleshooting, and improvements. + Lead complex manufacturing investigations and deviations, ensuring thorough root cause analysis and ... strategies and optimize product lifecycle management + Lead root cause investigations for manufacturing deviations and implement corrective and preventive actions +… more
    Otsuka America Pharmaceutical Inc. (07/15/25)
    - Related Jobs
  • Market Planning Consultant

    RELX INC (Springfield, IL)
    …of Anti-Money Laundering/Counter Terrorist Financing, Identity Authentication & Verification, Fraud and Credit Risk mitigation and Customer Data Management. You ... compliance, and a minimum of five years of experience conducting complex investigations involving various typologies + Cross-functional leadership and the ability to… more
    RELX INC (08/08/25)
    - Related Jobs