• Clinical Fraud Investigator II - Registered Nurse…

    Elevance Health (Woburn, MA)
    …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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  • Data Analyst

    Point32Health (Canton, MA)
    …individuals to join our organization as an Analytics & Triage Fraud Analyst within our Special Investigations Unit (" SIU "). The Analytics & Triage Fraud ... Analyst is an essential team member of the SIU , responsible for analyzing claim trends, patterns and outliers, developing and refining queries to detect potentially… more
    Point32Health (12/20/25)
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  • Senior Manager, Compliance Program

    Point32Health (Canton, MA)
    …report on the effectiveness of corrective action plans. + Collaborate with the Fraud special investigations unit to ensure program meets CMS requirements. + ... in a lawful and ethical manner. + Manage the compliance unit 's administrative duties, including organizing and maintaining relevant documents; preparing necessary… more
    Point32Health (12/23/25)
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  • Investigator 1 - FWA Prepayment Review

    Point32Health (Canton, MA)
    …essential team member of the Special Investigation Unit (" SIU ") responsible for leading complex provider investigations related to fraud, waste, and ... be responsible for conducting high-volume Pre-Payment Fraud Waste & Abuse ("FWA") investigations under the direction of the Manager, FWA Prepayment Review. The… more
    Point32Health (10/30/25)
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  • Fraud and Waste Investigator

    Humana (Boston, MA)
    …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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  • Outside Property Claim Representative

    Travelers Insurance Company (West Bridgewater, MA)
    …internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit . + ... handling throughout the claim life cycle (customer contacts, coverage, investigation , evaluation, reserving, negotiation and resolution) including maintaining full… more
    Travelers Insurance Company (12/23/25)
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  • Property Adjuster Specialist - Field

    USAA (Boston, MA)
    …characteristics. + Identifies coverage concerns, reviews prior loss history, determines and creates Special Investigation Unit ( SIU ) referrals, when ... treat each other and our members. Be part of what truly makes us special and impactful. **The Opportunity** As a dedicated Property Adjuster Specialist, you will… more
    USAA (11/25/25)
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  • Healthcare Analytics Business Consultant (SQL…

    CVS Health (Boston, MA)
    …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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