- Centene Corporation (Frankfort, KY)
- …Position acts as a subject matter expert for the Contractor's Program Integrity unit to reduce Fraud, Waste and Abuse of Medicaid services within Kentucky. Provides ... + Manage and coordinate cases being investigated by the SIU + Maintain all vendor cases + Assist with...Maintain all vendor cases + Assist with conducting complex investigations , including on-site investigations , review, complete and… more
- 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 (Louisville, KY)
- …accountability for compliance by overseeing, follow-up and resolution of 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… more
- CVS Health (Frankfort, KY)
- …are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a leading health insurance organization. This is ... datasets. + Design, develop, and maintain complex data analyses to support investigations of potential fraud, waste, and abuse in Medicaid claims and provider… more