- State of Massachusetts (Boston, MA)
- …seeking an experienced and dedicated individual to fill the role of Director for the Special Investigations Unit . In this role, the Director will be ... through managing and monitoring all clinical and administrative operations of the Special Investigations Unit . This specialized unit is responsible for… more
- LA Care Health Plan (Los Angeles, CA)
- Director, Compliance on Special Investigations Unit and Fraud, Waste and Abuse Job Category: Administrative, HR, Business Professionals Department: ... Special Investigations Unit Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 12591 Salary Range: $135,136.00 (Min.) - $175,676.00… more
- CVS Health (Topeka, KS)
- …Summary** We are 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, waste and abuse (FWA). **Key… more
- USAA (Louisville, KY)
- …truly makes us special and impactful. **The Opportunity** As a dedicated **Manager, Special Investigations Unit for Property & Casualty** , you will be ... actions and decisions to carry out proactive claim's projects and investigations . + Reviews and evaluates investigation recommendations from investigators to ensure… more
- The Cigna Group (Bloomfield, CT)
- **Fraud Senior Advisor - Special Investigations Unit (SIU) Matter Resolution** Our organization is a leader in healthcare services, committed to integrity, ... accountability and collaboration. **Position Overview** The Fraud Senior Advisor - Special Investigations Unit (SIU) Matter Resolution plays a critical role… more
- The Robison Group (Brooklyn, NY)
- …and speaking Spanish. This is a remote opportunity for part-time employment in our Special Investigations Unit (SIU). As an SIU Investigator, you will ... 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
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Supervisor - Special Investigations Unit Clinical Location: Hybrid | Eagan, Minnesota ... and regulatory requirements. * Lead complex recovery projects, audits and investigations working with cross functional teams and presenting findings to appropriate… more
- CVS Health (Concord, NH)
- …The Senior Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding ... practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must… more
- City of New York (New York, NY)
- …responsible for directing criminal and/or non-criminal, unique, highly confidential and sensitive investigations . The Special Investigation Unit (SIU) is ... investigators, engaged in the performance of confidential, highly complex, and/or special investigations involving surveillances, interrogation of subjects and… more
- Humana (Dayton, OH)
- …Department of Medicaid (ODM) and other agencies such as the Medicaid Fraud Control Unit (MFCU) and coordinate all aspects of FWA activities in Ohio to increase ... to encourage sensible and culturally-competent business standards + Oversee internal investigations of FWA compliance issues + Work with the Contract Compliance… more