- USAA (San Antonio, TX)
- …of 10 consecutive business days each calendar year. As a dedicated with ** Director , Special Investigations Unit ( SIU ),** you will be responsible for ... and fraud investigation programs and management of the Life Special Investigation Unit ( SIU ) staff....Experience to include broad understanding of procedures related to SIU investigations . + Knowledge and experience in… more
- City of New York (New York, NY)
- …York City Department of Correction seeks to recruit a Director to oversee the Special Investigations Unit 's ( SIU ) Intelligence Team. Under the direct ... management level position will be responsible for conducting all investigations into allegations of misconduct and special ...role and responsibilities of the Assistant Commissioner of the Special Investigation Unit in his/her absence -… more
- State of Massachusetts (Boston, MA)
- …highly organized, mission-driven individual to fill the role of Area Program Manager (APM) for the Special Investigations Unit ( SIU ). The Special ... activities of the clinical staff, and reports to the Special Investigations Director . The selected...of Children & Families* **Title:** *Area Program Manager - Special Investigations Unit * **Location:** *Massachusetts-Boston-600… more
- Centene Corporation (New York, NY)
- …**Position Purpose:** Oversee a full range of waste, abuse and fraud investigations , audits and medical code editing scenarios. Ensure all audits adhere to ... and abuse guidelines. + Oversee the activities of the SIU for accurate and timely operational reviews and final...field or equivalent. 7+ years of related compliance and/or special investigation experience in managed care or CMS. **Please… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …health and medical management, network management, business operations, payment policy, legal, special investigations unit , audit and risk management, ... Summary: The Federal Employee Program (FEP) Department is a full business unit comprised of approximately 140 associates. It encompasses a member and provider… more
- Fallon Health (Worcester, MA)
- …Audit Manager, theAnalyze and interpret patient medical records pertaining to FWA investigations Compare to information submitted on the claims in order to determine ... Interface with other clinicians including internal Medical Directors Provide training to SIU staff related to clinical topics as neededFWA Manager will oversees the… more
- AIG (Atlanta, GA)
- …must have significant experience with Workers' Compensation as a Claims Manager/ Director (managing a team of Claims Professionals with wide-ranging state ... as State Regulatory projects (ie State Regulatory Audits, California SIU /Fraud Audits, Workers' Compensation post project/handling reviews, etc.) must be… more