- Bassett Healthcare (Cooperstown, NY)
- …and enjoy the best quality of life possible. About the department Bassett Medical Center's Special Care Unit is a 24-bed intermediate care unit , serving as ... to meet the needs of our rural community. The Special Care unit is consistently hiring for...managerial observation + Helps to identify clinical problems requiring investigation as measured by co-worker feedback and managerial observation.… more
- CVS Health (Sacramento, CA)
- …And we do it all with heart, each and every day. Medical Director - SIU ( Special Investigations Unit ) CVS Health - Special Investigations ... remote based, work from home role.** Key Responsibilities: The Special Investigations Unit (SIU) Medical...Investigators, Managers, and Directors in matters pertaining to the investigation of suspected healthcare fraud cases + Develops and… more
- Providence (Oakland, CA)
- **Description** **Investigator External Audit Special Investigations Unit \*Remote The SIU Audit Investigator supports the compliance related activities of ... the Special Investigations Unit (SIU) at...activities at the Health Plan. This includes the identification, investigation and correction of fraudulent and/or abusive billing and… 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 ... utilizing their investigative skills to conduct a variety of investigations on insurance related matters; such as auto and...+ Make sound judgments during the course of the investigation . + Provide timely progress updates. + Complete detailed… more
- CVS Health (Hartford, CT)
- …do it all with heart, each and every day. The **Senior RFI Analyst** within the Special Investigations Unit (SIU) plays a key role in supporting fraud, ... waste, and abuse investigations by managing and responding to Requests for Information...Medicaid and Medicare programs - Familiarity with state-specific fraud investigation protocols (eg, Texas OIG, Florida AHCA) - Prior… more
- Molina Healthcare (Louisville, KY)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, ... investigation , reporting, and when appropriate, recovery of money related...assessments of FWA allegations, and end to end full investigations , including but not limited to witness interviews, background… more
- City of New York (New York, NY)
- …for one (1) Associate Benefits Opportunity Specialist, Level 1 to function as SPECIAL EVIDENCE PROCESSING UNIT (SEPU) SPECIALIST who will: - Review and ... self-sufficiency as quickly as possible. The Fair Hearing Specialized Evidence Packet Unit (SEPU) prepares evidence packets used by the Agency Representatives to… more
- Geisinger (Danville, PA)
- …Responsible for the strategic direction, planning, oversight, and operation of the Special Investigations ("SI") and Program Integrity ("PI") teams. Develops and ... directs the prevention, detection and investigation of anti-fraud, waste and abuse (FWA)program processes and...Job Duties + Provides leadership and strategic direction of Special Investigations and Program Integrity units spanning… more
- Centene Corporation (Jefferson City, MO)
- …correcting fraud, waste, and abuse ("FWA") in healthcare billing through investigation and coordination with internal and external stakeholders. Responsible for ... and executing strategies that ensure high-quality, timely, value-generating FWA investigations in compliance with legal, regulatory, and contractual requirements.… 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...while giving guidance and direction to team on case investigation steps and actions. + Works with leadership to… more
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