- Molina Healthcare (AZ)
- **Knowledge/Skills/Abilities** Acts as liaison between Special Investigations Unit ( SIU ) operations and contracted vendor(s) to assure a smooth workflow ... Associate Vice President of Fraud, Waste and Abuse (FWA) and Associate Vice President of Special Investigations Unit ( SIU ) to oversee the special … more
- CareFirst (Baltimore, MD)
- …alignment of clinical reviews for dental, medical quality of services and clinical Special Investigation Unit ( SIU ) research. Updates dental and medical ... (all benefits/incentives are subject to eligibility requirements). **Department** Dental Director **Equal Employment Opportunity** CareFirst BlueCross BlueShield is an… 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
- GuideOne Insurance (Dallas, TX)
- …you. Accountabilities: + This position handles Commercial General Liability, Director 's & Officer Liability, Employment Practices Liability, Commercial Auto ... claim. + Recognizes and pursues recovery opportunities and prepares submissions to SIU when indicated. + Assigns and supervises field examiners and vendor resources,… more