- State of Massachusetts (Boston, MA)
- …highly organized, mission-driven individual to fill the role of Area Program Manager (APM) for the Special Investigations Unit ( SIU ). The Special ... The Area Program Manager is a member of the SIU senior management team, is involved with all aspects...of Children & Families* **Title:** *Area Program Manager - Special Investigations Unit * **Location:** *Massachusetts-Boston-600… more
- Capital One (Richmond, VA)
- …3 (12073), United States of America, Richmond, Virginia AML Sr. Investigator I - Special Investigations Unit **Anti-Money Laundering Sr. Investigator I - ... Complex Investigations Unit , Special Investigations Unit...- Self-manage a queue of alerts, cases, and closing investigations -Helps maintain operations of a SIU … more
- ICW Group (Sacramento, CA)
- …opportunities to contribute, develop, and belong. **PURPOSE OF THE JOB** The purpose of the Special Investigations Unit ( SIU ) Coordinator is to provide ... project and administrative support to the SIU team. This role works independently and proactively to...securely stored.** + Serves as the guardian of the Consolidation/ Special Adjudication Unit (SAU) work with outside… more
- Capital One (Mclean, VA)
- …(19050), United States of America, McLean, Virginia Anti-Money Laundering Subject Matter Expert (SME) - Special Investigations Unit ( SIU ) The Special ... Investigations Unit in the AML Department performs specialized investigations to assess risks presented in particular circumstances. A Subject Matter Expert… more
- UPMC (Pittsburgh, PA)
- …4:30 pm This is a remote position. Under the direction of the manager, the Special Investigations Unit ( SIU ) Investigator is responsible for ... UPMC Health Plan has an exciting opportunity for a Special Investigations Unit Investigator position....supporting current SIU staff and manager with investigations and special projects. **Responsibilities:** + Maintain… more
- The Robison Group (Kansas City, MO)
- …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
- Capital One (Mclean, VA)
- Center 2 (19050), United States of America, McLean, Virginia Special Investigations Unit ( SIU ) Anti-Money Laundering Supervisor The Anti-Money Laundering ... supervises various AML processes, which might include suspicious activity investigations , currency transaction reporting, global sanctions screening, enhanced due… more
- CVS Health (Columbus, OH)
- …convenient and affordable. **Position Summary** Kentucky Resident is preferred The SIU Investigator conducts investigations to effectively pursue the prevention, ... in identifying resources and best course of action on investigations . - Cooperates with federal, state, and local law...experience working on health care fraud, waste, and abuse investigations and audits required or equivalent investigations … more
- CVS Health (Columbus, OH)
- …personal, convenient and affordable. **Position Summary** + Conduct high level, complex investigations of known or suspected acts of healthcare fraud, waste and ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims...presentations to internal and external customers regarding ongoing case investigations . **Required Qualifications** + 3-5 years investigative experience in… more
- CVS Health (Columbus, OH)
- …Summary:** As a Senior Investigator you will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse. Routinely ... in identifying resources and best course of action on investigations - Serves as back up to the Team...years of working health care fraud, waste and abuse investigations . **Pay Range** The typical pay range for this… more
- 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
- 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
- Allied Universal (St. Paul, MN)
- …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
- USAA (San Antonio, TX)
- …part of what makes us so special ! **The Opportunity** As a dedicated **Manager, Special Investigations Unit for Property & Casualty** , you will be ... 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
- NJM Insurance (Trenton, NJ)
- NJM is considering 2025 summer interns for our Special Investigations Unit , ( SIU ). Interns for the summer season will assist the SIU in anti-fraud ... gathering, and leveraging internal and external data sources to support SIU 's policy and claim investigations . The SIU Intern will gain work experience while… more
- CVS Health (Hartford, CT)
- …solutions to make health care more personal, convenient and affordable. **Position Summary** The Special Investigations Unit ( SIU ) is looking for an ... analytically driven individual who is skilled at identifying outliers through data extraction and analysis. The lead reviewer is accountable for the validation of existing Fraud, Waste and Abuse business rules/leads designed to detect aberrant billing patterns… more
- CareFirst (Columbia, 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
- USAA (Chicago, IL)
- …+ Leads high exposure, high profile and critical work assignments, and special investigations involving sophisticated niche fraud referrals, (examples: organized ... Come be a part of what makes us so special ! **The Opportunity** As a dedicated SIU ...members from potential fraudulent claims by investigating complex fraud investigations with significant financial impact to USAA. This may… more
- 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
- 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