- Centene Corporation (Columbus, OH)
- …and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud ... and abuse. Conduct investigations of potential waste, abuse, and fraud Document activity...for referral to Federal and State agencies Complete various special projects and audits Performs other duties as assigned… more
- Humana (Dayton, OH)
- …Department of Medicaid (ODM) and other agencies such as the Medicaid Fraud Control Unit (MFCU) and coordinate all aspects of FWA activities in Ohio to increase ... to encourage sensible and culturally-competent business standards Oversee internal investigations of FWA compliance issues Work with the Contract Compliance… more
- CVS Health (Olympia, WA)
- …do it all with heart, each and every day. Position Summary Conducts investigations to effectively pursue the prevention, investigation and prosecution of ... to comply with state regulations mandating fraud plans and practices. Conducts investigations of known or suspected acts of healthcare fraud and abuse. Communicates… more
- Molina Healthcare (Louisville, KY)
- …to the SIU Manager. This position will be accountable for tracking on investigations conducted by his/her team and will provide oversight and guidance throughout the ... life of an investigation as well as QA reviews and approvals. In...assignments effectively and timely. Manage the flow of day-to-day investigations . Perform assessment that QA measures were complete and… more
- Molina Healthcare (Phoenix, AZ)
- …or 5+ years of experience working in a FWA / SIU or Fraud investigations Thorough knowledge of PC based software including Microsoft Word (edit/save documents) and ... State & Federal laws and regulations pertaining to health insurance, investigations & legal processes (Commercial insurance, Medicare, Medicare Advantage, Medicare… more
- ExxonMobil (Baytown, TX)
- …Research Institutes and Academia, key vendors and suppliers) + Provides technical reviews of special unit operations, unit operating changes / projects, and ... ensuring the seamless operation of all systems within a designated business unit . This position is essential to maintaining reliability, efficiency, and safety… more
- Allied Universal (Cleveland, TN)
- …explore a career with us and make a difference. Allied Universal is hiring a Special Investigations Unit (SIU) Investigator. Special Investigations ... ensuring thorough documentation and effective communication with clients and their Special Investigation Unit Supervisor QUALIFICATIONS (MUST HAVE):… more
- UnitedHealth Group (Tampa, FL)
- …Caring. Connecting. Growing together. Work at home! The Medical Director for UnitedHealthcare's Investigations Unit (UHC IU) is a valuable national leader for ... findings, actions and outcomes to be relied on in investigations of fraud, waste, and abuse cases in accordance...experience in health care fraud, waste, and abuse (FWA) investigations Broad knowledge and experience in state and federal… more
- Travelers Insurance Company (Washington, DC)
- …internal and external customers/business partners. Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit . ... handling throughout the claim life cycle (customer contacts, coverage, investigation , evaluation, reserving, negotiation and resolution) including maintaining full… more
- Travelers Insurance Company (Redlands, CA)
- …internal and external customers/business partners. Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit . ... handling throughout the claim life cycle (customer contacts, coverage, investigation , evaluation, reserving, negotiation and resolution) including maintaining full… more
- USAA (Colorado Springs, CO)
- …carrier). Identifies coverage concerns, reviews prior loss history, determines, and creates Special Investigation Unit (SIU) referrals, when appropriate. ... we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Auto Adjuster you will manage file… more
- Travelers Insurance Company (Richmond, VA)
- …other internal and external customers/business partners. Recognizes when to refer claims to Special Investigations Unit and/or Subrogation Unit . Performs ... handling throughout the claim life cycle (customer contacts, coverage, investigation , evaluation, reserving, negotiation and resolution) including maintaining full… more
- USAA (Springfield, MA)
- …Identifies coverage concerns, reviews prior loss history, determines and creates Special Investigation Unit (SIU) referrals, when appropriate. ... we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Property Adjuster Specialist, you will work… more
- UnitedHealth Group (Minneapolis, MN)
- …four days per week. Primary Responsibilities: Provide legal counsel to the UnitedHealthcare Special Investigations Unit regarding fraud, waste, and abuse and ... including, but not limited to: fraud, waste and abuse, payment integrity, special investigations , litigation support, claim payment strategy and policy… more
- RELX INC (Atlanta, GA)
- …at the link below. https://risk.lexisnexis.com/government About our Team The Public Safety Special Investigative Unit (SIU) is comprised of former law ... The SIU team aids law enforcement during critical incidents and major investigations and is available to provide support remotely or onsite, when applicable.… more
- Compass Group, North America (San Mateo, CA)
- Bon Appetit Position Title: Multi- Unit F&B Director of Operations Pay 16 Reports To: Salary: 145,000-165,000 Other Forms of Compensation: Our Passion is Food! At Bon ... corporate recipe book or our chefs microwaving the lunch special . We do not have standardized recipes or central...our people! Job Summary We're seeking a seasoned, visionary Multi- Unit F&B Director of Operations to lead a high-performing… more
- Palo Alto Networks (Santa Clara, CA)
- …our personalized learning opportunities - just to name a few! Your Career As a Unit 42 Recovery Specialist, you will play a critical role in assisting our customers ... computing and networking environments following security incidents. Working in conjunction with the Unit 42 service delivery team, you will lead and oversee Unit … more
- Palo Alto Networks (Portland, OR)
- …a few! Your Career We are seeking a driven problem solver to join our Unit 42 Managed Detection and Response (MDR) team. Our team is responsible for customers ... will join a team of leaders who overlook the Unit 42 MDR team to ensure premium delivery to...leveraged Advantages Having worked in SOC analysis or an investigation environment Having worked in Incident Response environment The… more
- Takeda Pharmaceuticals (Boston, MA)
- …Ethics & Data Privacy Officer at the Director level , supporting our Oncology Business Unit (OBU) and reporting directly to the Head of Ethics & Compliance, OBU . In ... connection with digital and data privacy matters. Privacy Incidents: Support investigation of privacy incidents, reporting obligations and remediation efforts. Team… more
- Indorama Ventures (Port Neches, TX)
- …as necessary. + Perform required sample analyses and record results as required. Perform special analyses as required by unit supervision and report results. + ... EH&S and other mandatory training. + Communicate additional training needs/issues to unit supervision. + Updates job knowledge by cross-training and completing … more
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