• Area Program Manager - Special

    State of Massachusetts (Boston, MA)
    …mission-driven individual to fill the role of Area Program Manager (APM) for the Special Investigations Unit ( SIU ). The Special Investigations ... DCF employees and specific community stakeholders. The Area Program Manager is a member of the SIU ...& Families* **Title:** *Area Program Manager - Special Investigations Unit * **Location:** *Massachusetts-Boston-600… more
    State of Massachusetts (09/14/24)
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  • Special Investigations Unit

    UPMC (Pittsburgh, PA)
    …pm This is a remote position. Under the direction of the manager , the Special Investigations Unit ( SIU ) Investigator is responsible for investigating ... UPMC Health Plan has an exciting opportunity for a Special Investigations Unit Investigator position....role includes supporting current SIU staff and manager with investigations and special more
    UPMC (11/22/24)
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  • Manager , SIU - Dallas, Houston or

    USAA (San Antonio, TX)
    …be a part of what makes us so special ! **The Opportunity** As a dedicated ** Manager , Special Investigations Unit for Property & Casualty** , you will ... of investigative tools and techniques to guide and coach special investigators. + Demonstrated ability to build and maintain...to demonstrate monthly productivity and cycle time outcomes from investigations assigned to the SIU team. +… more
    USAA (11/22/24)
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  • Nurse and CPC - Clinical Fraud Investigator II…

    Elevance Health (Los Angeles, CA)
    …questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other internal areas on matters of mutual concern. ... **Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & Abuse** **Location:** This position will work...clinical evaluation of the collected data. + Performs in-depth investigations on identified providers as warranted. + Examines claims… more
    Elevance Health (10/01/24)
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  • Healthcare Fraud Manager (Aetna SIU

    CVS Health (Columbus, OH)
    …convenient and affordable. **Position Summary** Aetna is seeking an experienced Healthcare Fraud Manager to lead and oversee a team of investigators in our efforts ... environment. + Direct and oversee all fraud detection activities and investigations , ensuring alignment with organizational objectives and compliance standards. +… more
    CVS Health (11/21/24)
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  • Investigator Assistant - Carelon Payment Integrity…

    Elevance Health (Columbus, GA)
    …Assistant** is responsible for providing administrative support to the investigative unit and performing research on data to assist in identifying cases ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
    Elevance Health (11/24/24)
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  • Compliance Manager - Must Reside…

    Magellan Health Services (San Diego, CA)
    …the local compliance committee meetings. + Coordinates activities with the Internal Audit and Special Investigations Unit ( SIU ) on compliance matters ... Submits reports to the Quality Improvement Committee (QIC), Compliance Committee, Business Unit Manager , and the corporate Compliance Department as appropriate.… more
    Magellan Health Services (11/15/24)
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  • RN Clinical Provider Post Service Review…

    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, ... Federal Employee Program (FEP) Department is a full business unit comprised of approximately 140 associates. It encompasses a...Position Summary: The RN Clinical Provider Post Service Review Manager , led by a Registered Nurse, is responsible… more
    Blue Cross Blue Shield of Massachusetts (10/23/24)
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  • Senior Manager , Compliance

    Point32Health (Canton, MA)
    …effectiveness of corrective action plans. + **Fraud Prevention:** Work with the Fraud Special Investigations Unit to ensure compliance with CMS requirements. ... click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Compliance Senior Manager will report to the Government Programs Compliance Officer. This… more
    Point32Health (10/29/24)
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  • Fraud Waste and Abuse (FWA) Audit Manager

    Fallon Health (Worcester, MA)
    …training to SIU staff related to clinical topics as neededFWA Manager will oversees the day-to-day operations over investigations and allegations into ... of purpose:** Under the general direction of the Senior Internal Audit Manager , theAnalyze and interpret patient medical records pertaining to FWA investigations more
    Fallon Health (11/09/24)
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  • Claims TPA Regulatory Governance and Performance…

    AIG (Atlanta, GA)
    …to manage risk. Join us as a Claims TPA Regulatory Governance and Performance Manager to play your part in that transformation. It's an opportunity to grow your ... for General Insurance. Your Contribution at AIG as a TPA State Regulatory Performance Manager : As a Leader within the TPA Claims Governance team and an influencer at… more
    AIG (11/12/24)
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  • Catastrophe Outside Property Claim Professional…

    Travelers Insurance Company (Columbus, OH)
    …internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit . + ... Identifies and refers claims with Major Case Unit exposure to the manager . + Performs administrative functions such as expense accounts, time off reporting, etc.… more
    Travelers Insurance Company (10/01/24)
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  • Outside Property Claim Representative

    Travelers Insurance Company (Youngstown, OH)
    …internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit . + ... Identifies and refers claims with Major Case Unit exposure to the manager . + Performs administrative functions such as expense accounts, time off reporting, etc.… more
    Travelers Insurance Company (11/21/24)
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  • Outside Property Claim Representative Trainee

    Travelers Insurance Company (Youngstown, OH)
    …internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit . + ... Identifies and refers claims with Major Case Unit exposure to the manager . + Performs administrative functions such as expense accounts, time off reporting, etc.… more
    Travelers Insurance Company (11/21/24)
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  • Fleet Technician I

    Sysco (Wilsonville, OR)
    …maintenance under the guidance of fleet technician II & III or fleet manager on vehicles and equipment to maximize the safety, reliability, and cost efficiency ... fleet technician II & III or fleet supervisor or manager in accordance with all federal, state and local...manufacturers + Apprentice will be required to complete Sysco SIU training modules for safety and other required courses.… more
    Sysco (11/27/24)
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  • Liability Claims Analyst / Bodily Injury Analyst

    Flynn Restaurant Group (Independence, OH)
    …such as chairs, stools, rugs and other materials promptly. + Request authority from manager by writing up special and general damages with liability explanation ... or court appointed liens and incorporate in settlements correctly. + Updating Manager timely when new information is received throughout investigation with to ensure… more
    Flynn Restaurant Group (11/16/24)
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  • Surveillance Investigator

    The Robison Group (Albuquerque, NM)
    …with education and experience. OPPORTUNITIES FOR GROWTH WITHIN THE COMPANY INCLUDE: SIU work, Field Supervisor, Field Operations Manager , Case Management, etc. ... Individuals selected for the position will be expected to perform investigations of workers compensation claims, liability investigations , multi-line insurance… more
    The Robison Group (11/26/24)
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  • Mgr, Business Compliance

    CVS Health (Hartford, CT)
    …current skills and development needs. + Assess training needs and collaborate with the SIU Sr. Manager to create development plans for team members. + Develop ... for ensuring the quality and integrity of healthcare fraud and abuse investigations . This role involves overseeing the training and development of team members,… more
    CVS Health (11/22/24)
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  • Auto Liability Claim Rep Trainee

    Travelers Insurance Company (Hunt Valley, MD)
    …in on-going training sessions for the inside auto business. + Works closely with Unit Manager or mentor to promptly resolve assigned claim. + Customer ... and forwards appropriate files to subject matter experts (ie, Subrogation, SIU , Property, Adverse Subrogation, etc.). + Reserving: + Establishes timely and… more
    Travelers Insurance Company (11/20/24)
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  • Customer Service Rep

    Sysco (Orlando, FL)
    …of hotel and operational supplies. **Primary Responsibilities:** **Customer & Territory Manager Support:** + Answer incoming calls and emails from TMs. Research ... with management. **Training** + Regularly participate in Sysco Interactive University ( SIU ), vendor and other company training programs. **Communicate regularly with… more
    Sysco (11/19/24)
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