• Manager Special Investigation Unit

    Corewell Health (Grand Rapids, MI)
    …SITE - Priority Health - 1231 E Beltline - Grand Rapids Department Name PH - Special Investigations Unit Employment Type Full time Shift Day (United States ... Job Summary - Manager Special Investigation Unit The SIU...organization + Direct and oversee a broad range of investigations and audits related to FWA, including medical… more
    Corewell Health (07/19/25)
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  • Manager Special Investigations…

    AmeriHealth Caritas (Newtown Square, PA)
    …direct supervision of the Director , SIU the Pharmacy Manager in the Special Investigations Unit ( SIU ) will lead efforts to detect, investigate ... ; The manager must have the ability to determine correct coding, review claims, medical records and billing data from all types of healthcare providers for aberrant… more
    AmeriHealth Caritas (08/02/25)
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  • Financial Crimes Emerging Risk and Trends…

    US Bank (Minneapolis, MN)
    …skills and discover what you excel at-all from Day One. **Job Description** US Bank's Special Investigations Unit ( SIU ) is seeking an investigative ... for its Emerging Risk and Trends (ERT) Team. The SIU is part of US Bank's Enterprise Financial Crimes...reports directly to the Director of the Special Investigations Unit to ensure… more
    US Bank (08/02/25)
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  • Case Manager, RN (Multiple Openings!)

    Excellus BlueCross BlueShield (Rochester, NY)
    …as a liaison for activity generated by Customer Advocacy (CAU), Customer Service (CS), Special Investigations Unit ( SIU ), Provider Relations (PR), or ... Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse, Medical Director , Pharmacist, Geriatrics, etc.) to ensure continuity… more
    Excellus BlueCross BlueShield (06/18/25)
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  • Manager, Special Investigation

    CVS Health (Charleston, WV)
    …to match current skills and development needs. Assesses training needs and works with SIU Director on development plans for team members. Develops and maintains ... Health Care Anti-Fraud Association (AHFI) + Experience In Medicaid Compliance, Medicaid Investigations , MCO Medicaid FWA Unit in the following States: **Texas,… more
    CVS Health (08/01/25)
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  • Vice President, Ethics & Compliance

    Centene Corporation (Columbus, OH)
    …and federal requirements. + Will oversee Program Integrity Program, the Complaint, Grievance, Special Investigations Unit , and the fair hearing process, and ... including but not limited to coordinating with the Plan's quality management director , medical director , and behavioral health clinician. + Ensure that… more
    Centene Corporation (08/03/25)
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