• Special Investigations Unit

    The Hartford (GA)
    …help shape the future. We are seeking a talented Special Investigator to join our Special Investigations Unit ( SIU ). This position will be based out ... within his or her area of responsibility and leverage knowledge gained to SIU analytical resources. + Independently complete investigations in accordance with… more
    The Hartford (01/25/25)
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  • Anti-Money Laundering Subject Matter Expert (SME)…

    Capital One (Mclean, VA)
    Anti-Money Laundering Subject Matter Expert (SME) - Special Investigations Unit ( SIU ) The Special Investigations Unit in the AML Department ... (SME) will work closely with key stakeholders in the SIU and outside of the SIU when...+ Collaborating with investigators and people leaders on complex investigations and/or special projects, often functioning in… more
    Capital One (12/09/24)
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  • Part Time Private Investigator - Special

    The Robison Group (Brooklyn, NY)
    …searches, and other investigative tasks. This is a remote opportunity for part-time employment in our Special Investigations Unit ( SIU ). As an SIU ... are interested in utilizing their investigative skills to conduct a variety of investigations on insurance related matters; such as auto and property theft, fire… more
    The Robison Group (01/23/25)
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  • AVP, Special Investigations

    BlueCross BlueShield of North Carolina (NC)
    **Job Description** The AVP Special Investigations Unit ( SIU ) is responsible for overseeing and managing fraud, waste, and abuse (FWA) detection, ... assets and reduce healthcare costs. This requires demonstrating vision in positioning the SIU with the right skill sets, cutting edge analytics tools, and robust… more
    BlueCross BlueShield of North Carolina (01/14/25)
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  • Student Intern ( Special

    LA Care Health Plan (Los Angeles, CA)
    Student Intern ( Special Investigations Unit ) Job Category: Administrative, HR, Business Professionals Department: Talent Strategy & HR Technology Location: ... Additional Information + Provide analytical support to active Healthcare Fraud investigations . + Conduct case intake from various sources including hotline… more
    LA Care Health Plan (12/07/24)
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  • Certified Professional Coder, Special

    CVS Health (Columbus, OH)
    …The Certified Professional Coder (CPC) will perform medical claim reviews to ensure compliance with coding practices through a comprehensive record review for ... Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world.… more
    CVS Health (01/04/25)
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  • Senior Fraud and Waste Investigator,…

    Humana (Indianapolis, IN)
    …Program Integrity (OMPP PI) 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
    Humana (12/19/24)
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  • Division of Confidential Investigations

    New York State Civil Service (White Plains, NY)
    …include answering, phones, photocopying, and other tasks, as needed. DCI is NYSIF's special investigations unit for the detection, investigation, and ... HELP No Agency Insurance Fund, State Title Division of Confidential Investigations Intern Occupational Category Enforcement or Protective Services Salary Grade… more
    New York State Civil Service (12/18/24)
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  • Special Investigation Unit Manager…

    CVS Health (Columbus, OH)
    …innovate and deliver solutions to make health care more personal, convenient and affordable. The Special Investigations Unit is seeking a Manager to lead our ... team of Certified Professional Coders (CPC). The Manager is responsible for overseeing and managing coding reviews for fraud detection, investigation, and prevention efforts to safeguard the organization's resources and reduce healthcare costs. This role… more
    CVS Health (12/25/24)
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  • Senior Investigator, Special Investigative…

    CVS Health (Trenton, NJ)
    …are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU ). In this role, you will manage ... fraud, waste and abuse (FWA). **Key Responsibilities** + Conduct high level, complex investigations of known or suspected acts of healthcare fraud, waste and abuse.… more
    CVS Health (01/18/25)
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  • Analyst, Special Investigative Unit

    CVS Health (Columbus, OH)
    …Must be flexible to work EDT hours (8:00 am - 5 pm EDT) The Special Investigations Unit ( SIU ) is looking for an analytically driven individual who ... billing patterns and reviewing incoming referrals to determine if additional investigations are warranted. **Fundamental Components:** -Research and ad hoc report… more
    CVS Health (01/18/25)
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  • SIU Investigator - Part-Time

    Allied Universal (Des Moines, IA)
    …plans, employee assistance programs, and exclusive perks. Allied Universal(R) is hiring a Special Investigations Unit ( SIU ) Investigator. Special ... designated regional area. + Proficient in utilizing laptop computers and cell phones. + Special Investigative Unit ( SIU ) Compliance knowledge + Ability to… more
    Allied Universal (01/23/25)
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  • Director, SIU / Fraud Waste and Abuse…

    Molina Healthcare (Columbus, OH)
    **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
    Molina Healthcare (01/21/25)
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  • Senior Investigator, Pharmacy (Aetna SIU )

    CVS Health (Frankfort, KY)
    …We are seeking an experienced Senior Healthcare Fraud Investigator (Pharmacy) to join our Special Investigations Unit . In this role, you will manage complex ... fraud, waste and abuse (FWA). **Key Responsibilities** + Conducts high level, complex investigations of known or suspected acts of Pharmacy Fraud, Waste and Abuse. +… more
    CVS Health (01/11/25)
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  • Senior Investigator (Hybrid)

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** The role of the Special Investigations Unit ( SIU ) Investigator, Sr. is to assist in the reduction and recuperation ... projects as assigned by management to meet the needs of the Special Investigations Unit . **QUALIFICATIONS:** **Education** Level: Bachelor's Degree… more
    CareFirst (11/27/24)
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  • Investigative Training Trainer (Remote - Eastern…

    RELX INC (Dayton, OH)
    …as a subject matter expert on LexisNexis and Accurint TraX (ZetX) solutions within the Special Investigations Unit ( SIU ). The Public Safety SIU ... the link below. https://risk.lexisnexis.com/government About our Team The LexisNexis(R) Public Safety Special Investigations Unit is comprised of former… more
    RELX INC (12/11/24)
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  • Deputy General Counsel

    State of Massachusetts (Boston, MA)
    …in litigation and as receiver. In addition, the Deputy General Counsel oversees the Special Investigations Unit ( SIU ) which supports the Division's ... reflect applicable legal, financial and other factors. * Oversee the Division's Special Investigations Unit , including supervising the Supervising … more
    State of Massachusetts (12/17/24)
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  • Crime Analyst - Embedded

    RELX INC (Concord, NH)
    …relationships with internal and external customers to raise brand awareness of the Special Investigations Unit . + Other duties as assigned. Qualifications ... Risk at the link below. https://risk.lexisnexis.com/government About our Team The Public Safety Special Investigative Unit ( SIU ) is comprised of former law… more
    RELX INC (12/04/24)
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  • Investigator II

    Premera Blue Cross (Mountlake Terrace, WA)
    …serve through our Healthsource blog: https://healthsource.premera.com/ . As a member of Premera's Special Investigations Unit ( SIU ), the **Investigator ... information and data, including financial data, in support of investigations of external fraud. The reports prepared by this...required. + Assist in developing, planning, and reporting the SIU budget. + Participate in special projects,… more
    Premera Blue Cross (01/17/25)
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  • Medicare Compliance Officer

    Centene Corporation (Austin, TX)
    …potential FWA, including the coordination of internal investigations with the Special Investigations Unit and the development of appropriate corrective ... development and implementation of Corrective Action Plans + Coordinating potential fraud investigations and referrals from and with the SIU , where applicable,… more
    Centene Corporation (01/10/25)
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