• Manager, Fraud and Waste, Special

    Humana (Lansing, MI)
    …and help us put health first** The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste ... goals. **Where You Come In** The Manager, Fraud and Waste coordinates investigation with law enforcement authorities. Assembles evidence and documentation to support… more
    Humana (12/24/25)
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  • Field Investigator - Macp/ACP/OOP

    Command Investigations (Detroit, MI)
    Investigations ) is seeking qualified, driven, and experienced candidates to join our special investigations unit as an ACP Investigator. SuperiorX ... demand for quality investigations to gather critical information, conduct special investigations , examine coverage/loss, and combat fraud, one case at… more
    Command Investigations (10/17/25)
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  • Clinical Fraud Investigator II - Registered Nurse…

    Elevance Health (Dearborn, MI)
    …questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other internal areas on matters of ... analysis and clinical evaluation of the collected data. + Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance… more
    Elevance Health (12/18/25)
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  • Fraud and Waste Investigator

    Humana (Lansing, MI)
    …Humana is looking for an experienced Healthcare Investigator to join its industry leading Special Investigations Unit . Do you enjoy speaking with members, ... opportunity to join Humana's SIU. The Fraud and Waste Professional conducts investigations of allegations of fraudulent and abusive practices. The Fraud and Waste… more
    Humana (12/24/25)
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  • Healthcare Analytics Business Consultant (SQL…

    CVS Health (Lansing, MI)
    …We are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a leading health insurance organization. ... datasets. + Design, develop, and maintain complex data analyses to support investigations of potential fraud, waste, and abuse in Medicaid claims and provider… more
    CVS Health (12/17/25)
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  • Senior Stop Loss Claims Analyst - HNAS

    Highmark Health (Lansing, MI)
    …and/or template. + Identifies potential discrepancies in claim submissions and involves the Special Investigation Unit as necessary. Identifies issues which ... can be used to educate/train internal staff, streamline, and improve processes and update documentation. + Assists leadership with performing client performance evaluations to assess the accuracy of client reports submitted to the organization, efficiency of… more
    Highmark Health (12/23/25)
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  • Payment Integrity Clinician

    Highmark Health (Lansing, MI)
    …billing practices and intervene for resolution and education or if necessary involve Special Investigation Unit or the Utilization Management area. ... **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment and retrospective review processes that are consistent with established industry and corporate standards and are within the Payment Integrity Clinician's professional discipline.Effectively function in… more
    Highmark Health (11/14/25)
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  • Special Education Teacher P11 - IBC

    State of Michigan (Ionia, MI)
    Special Education Teacher P11 - IBC Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/5166109) Apply  Special Education Teacher P11 - IBC ... Bellamy Creek Correctional Facility Opening Date 12/10/2025 Closing Date Continuous Bargaining Unit UNITED AUTO WORKERS (UAW) + Description + Benefits + Questions… more
    State of Michigan (12/11/25)
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  • Special Education Teacher-MRF

    State of Michigan (New Haven, MI)
    Special Education Teacher-MRF Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/4312825) Apply  Special Education Teacher-MRF Salary $28.88 - ... - Macomb Correctional Facility Opening Date 11/20/2024 Closing Date Continuous Bargaining Unit UNITED AUTO WORKERS (UAW) + Description + Benefits + Questions Job… more
    State of Michigan (11/30/25)
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  • Departmental Supervisor 11 - Quality Assurance…

    State of Michigan (Lansing, MI)
    Departmental Supervisor 11 - Quality Assurance Unit Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/5182182) Apply  Departmental Supervisor 11 ... - Quality Assurance Unit Salary $2,221.60 - $3,240.80 Biweekly Location Lansing, MI...a United States Citizen and pass a thorough background investigation to comply with Public Act 7 of 2008,… more
    State of Michigan (12/31/25)
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