• Lead Investigator, Special Investigative…

    Molina Healthcare (Covington, KY)
    **JOB DESCRIPTION** **Job Summary** Under direct supervision of the Manager, SIU , the Team Lead is responsible to lead a small team of investigators and provide ... on daily investigative activities as a back-up to the SIU Manager. This position will be accountable for tracking...Manager. This position will be accountable for tracking on investigations conducted by his/her team and will provide oversight… more
    Molina Healthcare (11/21/25)
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  • Manager, Special Investigative Unit

    Molina Healthcare (Louisville, KY)
    investigations . **KNOWLEDGE/SKILLS/ABILITIES** + Provides oversight and review of the SIU referral intake and investigation process while giving guidance and ... direction to team on case investigation steps and actions. + Works with leadership to maintain and revise policies and procedures, fraud, waste, and abuse plans,… more
    Molina Healthcare (10/16/25)
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  • Clinical Fraud Investigator II - Registered Nurse…

    Elevance Health (Louisville, KY)
    …questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other internal areas on matters of ... Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU ** **Location:** This role enables associates to work virtually full-time, with the… more
    Elevance Health (12/18/25)
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  • Fraud and Waste Investigator

    Humana (Frankfort, KY)
    …Humana is looking for an experienced Healthcare Investigator to join its industry leading Special Investigations Unit . Do you enjoy speaking with members, ... you, then you should strongly consider this amazing opportunity to join Humana's SIU . The Fraud and Waste Professional conducts investigations of allegations of… more
    Humana (12/24/25)
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  • Healthcare Analytics Business Consultant (SQL…

    CVS Health (Frankfort, KY)
    …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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