- 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
- Allied Universal (Cleveland, TN)
- …career with us and make a difference. Allied Universal is hiring a Special Investigations Unit (SIU) Investigator . Special Investigations Unit ... ensuring thorough documentation and effective communication with clients and their Special Investigation Unit Supervisor QUALIFICATIONS (MUST HAVE):… more
- Humana (Dayton, OH)
- …community and help us put health first This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring ... 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… more
- CVS Health (Atlanta, GA)
- …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)
- JOB DESCRIPTION Job Summary The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical providers. ... 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… more
- Centene Corporation (Frankfort, KY)
- …Position acts as a subject matter expert for the Contractor's Program Integrity unit to reduce Fraud, Waste and Abuse of Medicaid services within Kentucky. Provides ... by the SIU Maintain all vendor cases Assist with conducting complex investigations , including on-site investigations , review, complete and submit FWA referrals… 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
- Colorado State University (Fort Collins, CO)
- …applications must be received by 11:59pm (MT) on12/31/2025 Description of Work Unit The Microbiology, Immunology and Pathology ( MIP ) Department is comprised ... prions, and arthropod-borne infectious diseases, as well as the diagnostic investigation of naturally-occurring animal diseases. A leader in education, MIP provides… more
- UPMC (Pittsburgh, PA)
- …formfieldid="descriptionInt" UPMC Health Plan has an exciting opportunity for a Special Investigations Unit Investigator position. ... position. Under the direction of the manager, the Special Investigations Unit (SIU) Investigator is responsible for investigating assigned fraud, waste… more
- 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...referral to Federal and State agencies + Complete various special projects and audits + Performs other duties as… more
- The Robison Group (Brooklyn, NY)
- …is a remote opportunity for part-time employment in our Special Investigations Unit (SIU). As an SIU Investigator , you will be joining an incredible team ... utilizing their investigative skills to conduct a variety of investigations on insurance related matters; such as auto and...+ Make sound judgments during the course of the investigation . + Provide timely progress updates. + Complete detailed… more
- Allied Universal (Provo, UT)
- …career with us and make a difference. Allied Universal(R) 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
- Kemper (Doral, FL)
- …referred to and accepted for investigation by the Special Investigative Unit . Our Special Investigator will function as a remote investigator ... Investigator will conduct field as well as desk investigations of insurance claims...agencies as required by law and management. Keeps the Special Investigation Unit and field… more
- Humana (Dayton, OH)
- …community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring ... 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… more
- CVS Health (Atlanta, GA)
- …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. -… more
- Molina Healthcare (Covington, 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...effectively and timely. + Manage the flow of day-to-day investigations . + Perform assessment that QA measures were complete… more
- Command Investigations (Detroit, MI)
- …) is seeking qualified, driven, and experienced candidates to join our special investigations unit as an ACP Investigator . SuperiorX Investigations ... demand for quality investigations to gather critical information, conduct special investigations , examine coverage/loss, and combat fraud, one case at… more
- New York State Civil Service (Albany, NY)
- NY HELP No Agency Corrections and Community Supervision, Department of Title Investigator - Office of Special Investigations Occupational Category ... Be Determined Street Address NYS DOCCS - Office of Special Investigations Multiple Locations - see additional...upon the needs of the Department and OSI. An Investigator is responsible for conducting investigations pertaining… more
- State of Colorado (Denver, CO)
- …Justice Section is seeking an experienced investigator to join the Special Prosecutions Unit . In this role, you'll investigate allegations of criminal ... Special Prosecutions Investigator ( Special ...appropriate for investigation and prosecution by the Special Prosecutions Unit . As such, this position… more
