- Magellan Health Services (Boise, ID)
- …of Microsoft Excel, Access, Outlook, Word, and Power Point. General Job Information Title SIU Program Integrity Investigator - Remote (In Idaho) Grade 24 ... for comprehensive management and ownership of fraud, waste and abuse investigations including development and presentation of investigative results. This individual… more
- UPMC (Pittsburgh, PA)
- … highly preferred. Under the direction of the manager, the Special Investigations Unit ( SIU ) Investigator is responsible for investigating ... UPMC Health Plan has an exciting opportunity for a SIU Investigator ! This is a remote...healthcare oversight referrals. - Plan, organize and execute dental investigations or dental audits utilizing document review, witness interviews,… more
- Kemper (Doral, FL)
- …investigation by the Special Investigative Unit . Our Special Investigator will function as a remote investigator working from her/his residence ... Examinations Under Oath. This investigator will coordinate investigations with outside SIU contacts, the Department...agencies as required by law and management. Keeps the Special Investigation Unit and field managers advised… more
- The Robison Group (Brooklyn, NY)
- …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
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** The AVP Special Investigations Unit ( SIU ) is responsible for overseeing and managing fraud, waste, and abuse (FWA) detection, ... assets and reduce healthcare costs. This requires demonstrating vision in positioning the SIU with the right skill sets, cutting edge analytics tools, and robust… more
- USAA (Nashville, TN)
- …makes us special and impactful. **The Opportunity** We are looking for a SIU Investigator (mid-level). This is a desk position. Within defined guidelines and ... and regulations and policies and procedures. **This role is remote eligible. However, you must currently live in the...SIU experience conducting low to complex PNC fraud investigations OR a combination of Claims and Law Enforcement… more
- 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
- Centene Corporation (Columbus, OH)
- …and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud ... and abuse. + Conduct investigations of potential waste, abuse, and fraud + Document...referral to Federal and State agencies + Complete various special projects and audits + Performs other duties as… more
- Humana (Oklahoma City, OK)
- **Become a part of our caring community and help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator ... to join the Oklahoma Medicaid Team. This team of Investigators conducts investigations into allegations of fraud, waste, and abuse involving providers who submit… more
- Centene Corporation (Harrisburg, PA)
- …outpatient, ancillary, behavioral health care, laboratory, etc. Provides investigative support to the Special Investigations Unit ( SIU ) related to coding ... benefits including a fresh perspective on workplace flexibility. POSITION IS REMOTE CANDIDATE MUST HAVE EXPERIENCE INVESTIGATING OR IDENTIFYING BEHAVIORAL HEALTH… more