- CVS Health (Harrisburg, PA)
- …can be work from home anywhere in the United States. **Position Summary** The Special Investigations Unit (SIU) is looking for an analytically driven ... data extraction and analysis, dedicated to a specific self-funded plan sponsor. The lead reviewer is accountable for the validation of existing fraud waste and abuse… more
- Molina Healthcare (Cincinnati, OH)
- **JOB DESCRIPTION** **Job Summary** Under direct supervision of the Manager, SIU, the Team Lead is responsible to lead a small team of investigators and provide ... Manager. This position will be accountable for tracking on investigations conducted by his/her team and will provide oversight...provide oversight and guidance throughout the life of an investigation as well as QA reviews and approvals. In… more
- LA Care Health Plan (Los Angeles, CA)
- …motivating direct reports. Duties Leadership and Program Oversight: Lead LA Care's Special Investigations Unit (SIU) in overseeing the internal and ... Director, Compliance on Special Investigations Unit and...(DHCS), and state/federal requirements. Ensure effective case intake, triage, investigation , tracking, and resolution processes, including referral to law… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Supervisor - Special Investigations Unit Clinical Location: Hybrid | Eagan, Minnesota ... practices, contractual arrangements, Blue Cross licensure, and regulatory requirements. * Lead complex recovery projects, audits and investigations working with… more
- Centene Corporation (Oklahoma City, OK)
- …and Oklahoma markets. Develop internal processes for enhanced FWA detection and investigation completion. + Evaluate the department policies and procedures to ensure ... in billing and claims payment + Serve as a lead and investigate all possible fraud, waste and abuse...or equivalent experience. 6+ years of combined medical claim investigation , financial impact analysis, business analysis, compliance or fraud… more
- State of Connecticut, Department of Administrative Services (Bridgeport, CT)
- …In the Department of Social Services this class is accountable for supervising a unit engaged in performing investigations relevant to fraud and recovery of ... Social Services Investigations Supervisor - Fraud and Resources Hybrid Recruitment... in the fraud and recovery of public assistance unit . MINIMUM QUALIFICATIONS - SPECIAL EXPERIENCE One… more
- CVS Health (Salt Lake City, UT)
- …violations. This position is embedded within the International Special Investigations Unit (ISIU) and is designed to lead complex investigations into ... with heart, each and every day. **Position Summary** The Senior Analyst, Investigations at Aetna International plays a pivotal role in safeguarding the organization… more
- City of New York (New York, NY)
- …Yorkers will have a democracy they can truly trust. ABOUT THE DEPARTMENT The Investigations Unit works with other CFB units to ensure compliance with campaign ... of other regular people, not just wealthy donors and special interests. And we lift the veil on how...finance laws and regulations and seeks a Director of Investigations to lead a team of analysts… more
- Spokane County (Spokane, WA)
- Attorney 3 - Special Assaults Unit , Prosecutor Print (https://www.governmentjobs.com/careers/spokanecountywa/jobs/newprint/5104620) Apply Attorney 3 - ... Special Assaults Unit , Prosecutor Salary $104,833.96 -...refer the case back to the investigator for further investigation , or whether to decline criminal prosecution. + Prepares… more
- Veterans Affairs, Veterans Health Administration (Tucson, AZ)
- …-Minimum of 2 -3 years of recent experience in a GI Lab, Special Procedures Unit , or lnterventional Radiology setting. -Demonstrated experience in charge ... required for males born after 12/31/1959. Subject to background/security investigation . Selected applicants will be required to complete an...nurse or team lead roles. -Skilled in post-procedure monitoring, including sedation recovery,… more
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