- CVS Health (Sacramento, CA)
- …and more compassionate. And we do it all with heart, each and every day. Medical Director - SIU ( Special Investigations Unit ) CVS Health - Special ... remote based, work from home role.** Key Responsibilities: The Special Investigations Unit ( SIU...Investigators, Managers, and Directors in matters pertaining to the investigation of suspected healthcare fraud cases + Develops and… more
- 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 ... 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
- 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...activities at the Health Plan. This includes the identification, investigation and correction of fraudulent and/or abusive billing and… more
- CVS Health (Hartford, CT)
- …we 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, ... SIU related requirements. Prepares detailed preliminary and extensive investigation referrals to state and/or federal regulatory and/or law enforcement agencies… 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 (Milwaukee, WI)
- …hospital, clinic settings) or 5+ years of experience working in a FWA / SIU or Fraud investigations + Thorough knowledge of PC based software including ... **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical… more
- Molina Healthcare (Louisville, KY)
- … 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 and revise policies and procedures, fraud, waste, and abuse plans,… more
- Allied Universal (Rochester, NY)
- …on the position and eligibility. **Job Description:** Allied Universal(R) is hiring a Special Investigations Unit ( SIU ) Investigator. Special ... ensuring thorough documentation and effective communication with clients and their Special Investigation Unit Supervisor **QUALIFICATIONS (MUST HAVE):**… more
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