• Part Time Bilingual (Spanish) Private Investigator…

    The Robison Group (Brooklyn, NY)
    …writing, reading and speaking Spanish. This is a remote opportunity for part-time employment in our Special Investigations Unit ( SIU ). As an SIU ... are interested in utilizing their investigative skills to conduct a variety of investigations on insurance related matters; such as auto and property theft, fire… more
    The Robison Group (06/23/25)
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  • Manager, Fraud and Waste * Special

    Humana (Albany, NY)
    …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 ... works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals. The Manager, Fraud and Waste… more
    Humana (09/05/25)
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  • Senior Analyst, Special Investigative…

    CVS Health (Albany, NY)
    …Senior Healthcare Fraud Investigator to join our Dental/Pharmacy/Broker Investigative Team within Aetna's Special Investigations Unit . In this role, you will ... fraud, waste and abuse (FWA). **Key Responsibilities** + Conduct high level, complex investigations of known or suspected acts of healthcare fraud, waste and abuse.… more
    CVS Health (09/02/25)
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  • SIU Investigator

    Allied Universal (Staten Island, NY)
    …plans, employee assistance programs, and exclusive perks. 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
    Allied Universal (09/06/25)
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  • Case Manager, RN or Licensed Behavioral Health…

    Excellus BlueCross BlueShield (Dewitt, NY)
    …as a liaison for activity generated by Customer Advocacy (CAU), Customer Service (CS), Special Investigations Unit ( SIU ), Provider Relations (PR), or ... Sales & Marketing. + Ensuring all regulatory requirements are being met, such as NYS DOH, CMS, NCQA, and HEDIS, serving as internal auditor within the group. + Responsible for all aspects of the Case Management department functions including quality,… more
    Excellus BlueCross BlueShield (08/28/25)
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  • Community Health Assessment Field Nurse (Rochester…

    Excellus BlueCross BlueShield (Rochester, NY)
    …agencies (eg APS/CPS) as needed, and any suspected/possible Medicaid fraud to the Special Investigations Unit ( SIU ) or designated internal/external ... entity. + Communicates with all internal and external stakeholders to obtain the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members. + Adheres to all Corporate and Departmental policies… more
    Excellus BlueCross BlueShield (08/19/25)
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  • Claims Investigator

    Allied Universal (Buffalo, NY)
    …standards in their home state and within their designated region of the country + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to type 40+ ... As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation… more
    Allied Universal (09/06/25)
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  • Internal Investigator 2 Ocfs

    New York State Civil Service (Syracuse, NY)
    …No Telecommuting allowed? Yes County Onondaga Street Address Syracuse Regional Office - Special Investigations 333 East Washington St, City Syracuse State NY Zip ... Occupational Category Enforcement or Protective Services Salary Grade 23 Bargaining Unit M/C - Managerial/Confidential (Unrepresented) Salary Range From $86773 to… more
    New York State Civil Service (08/29/25)
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