- 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 ... to Department requests for information + Serve as a lead for the Kentucky market + Manage and coordinate...+ Manage and coordinate cases being investigated by the SIU + Maintain all vendor cases + Assist with… more
- Molina Healthcare (Covington, KY)
- **JOB DESCRIPTION** **Job Summary** Under direct supervision of the Manager, SIU , the Team Lead is responsible to lead a small team of investigators and ... on daily investigative activities as a back-up to the SIU Manager. This position will be accountable for tracking...Manager. This position will be accountable for tracking on investigations conducted by his/her team and will provide oversight… more
- AmeriHealth Caritas (Columbia, SC)
- …commensurate with position requirements in lieu of formal educational requirements for the Lead SIU Investigator position may be considered. + Valid ... investigations . + Performs necessary functions to support all aspects of SIU investigations and responsibilities to include, but not limited to: Intake;… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …OMIG's minimum investigator requirements as follows: Persons employed by the SIU as investigators shall be qualified by education or experience, which shall ... criminal justice or related field; or employment as an investigator in the SIU on or before...(BREADTH). + Expertise in complex clinical coding/reviewing assignments, difficult investigations and highly visible issues. (DEPTH). + Lead… more