- LA Care Health Plan (Los Angeles, CA)
- …Fraud, Waste and Abuse (FWA) is responsible for directing LA Care Health Plan's enterprise special investigations unit ( SIU ) and FWA program. The ... and motivating direct reports. Duties Leadership and Program Oversight: Lead LA Care's Special Investigations Unit ( SIU ) in overseeing the internal and… more
- CVS Health (Sacramento, CA)
- …seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU ), dedicated to a specific self-funded plan ... sponsor. In this role, you will manage complex investigations into suspected and known acts of healthcare fraud,...abuse (FWA). **Key Responsibilities** + Conduct high level, complex investigations of known or suspected acts of healthcare fraud,… more
- CVS Health (Sacramento, CA)
- …position can be work from home anywhere in the United States. **Position Summary** The Special Investigations Unit ( SIU ) is looking for an analytically ... and reviewing incoming referrals and leads to determine if additional investigations are warranted. **Key Responsibilities** + Identify, research, analyze and… more
- CVS Health (Sacramento, CA)
- …waste, abuse (FWA), and compliance violations. This position is embedded within the International Special Investigations Unit (ISIU) and is designed to lead ... with heart, each and every day. **Position Summary** The Senior Analyst, Investigations at Aetna International plays a pivotal role in safeguarding the organization… more
- Allied Universal (Fresno, CA)
- …best, explore a career with us and make a difference. Allied Universal(R) is hiring a Special Investigations Unit ( SIU ) Investigator. Special ... designated regional area. + Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to… more
- Elevance Health (Costa Mesa, CA)
- …questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other internal areas on matters of mutual concern. ... **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU ** **Location:** This role requires associates to be in-office 1 - 2 days… more
- Travelers Insurance Company (Walnut Creek, CA)
- …internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit . + ... Identifies and refers claims with Major Case Unit exposure to the manager. + Performs administrative functions such as expense accounts, time off reporting, etc. as… more
- Travelers Insurance Company (San Diego, CA)
- …internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit . + ... Identifies and refers claims with Major Case Unit exposure to the manager. + Performs administrative functions such as expense accounts, time off reporting, etc. as… more
- USAA (San Diego, CA)
- …+ Identifies coverage concerns, reviews prior loss history, determines, and creates Special Investigation Unit ( SIU ) referrals, when appropriate. + ... Agent (Army MOS 31D or Marine Corps 5821), Air Force Office of Special Investigations (OSI) Agent (Air Force Enlisted Code 7S), or in a Military Police (MP)… more