- LA Care Health Plan (Los Angeles, CA)
- …Fraud, Waste and Abuse (FWA) is responsible for directing LA Care Health Plan's enterprise special investigations unit ( SIU ) and FWA program. The ... and motivating direct reports. Duties Leadership and Program Oversight: Lead LA Care's Special Investigations Unit ( SIU ) in overseeing the internal and… 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 (Brooklyn, NY)
- …writing, reading and speaking Spanish. 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
- City of New York (New York, NY)
- …and/or non-criminal, unique, highly confidential and sensitive investigations . The Special Investigation Unit ( SIU ) is responsible for investigating ... The New York City Department of Correction seeks to recruit Deputy Directors for the Special Investigation Unit ( SIU ). Under the direction of the Executive… more
- CVS Health (Atlanta, GA)
- …all with heart, each and every day. **Position Summary** - Conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare ... to comply with state regulations mandating fraud plans and practices. - Conducts investigations of known or suspected acts of healthcare fraud and abuse. -… more
- Allied Universal (Burlington, VT)
- …best, explore a career with us and make a difference. 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
- Capital One (Plano, TX)
- AML Sr Investigator II- SIU Subject Matter Expert (SME) **The Special Investigations Unit in the AML Department** performs specialized investigations ... (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
- NJM Insurance (Trenton, NJ)
- …have had this excellent opportunity!" Overview NJM is considering 2026 summer interns for our Special Investigations Unit , ( SIU ). Interns for the summer ... place to learn and grow. The community is truly special ." Kyle: "I cannot recommend this internship enough to...and leveraging internal and external data sources to support SIU 's policy and claim investigations . The … more
- Command Investigations (Detroit, MI)
- … Investigations ) is seeking qualified, driven, and experienced candidates to join our special investigations unit as an ACP Investigator. SuperiorX ... demand for quality investigations to gather critical information, conduct special investigations , examine coverage/loss, and combat fraud, one case at… more
- City of New York (New York, NY)
- …Counsel, the Family Court, other OCSS divisions, OTDA, and other jurisdictions. The Special Investigations Unit ( SIU ) identifies and investigates ... senior management oversight and direction for OCSS' Administrative Enforcement, Interstate, Special Investigations and Employment Services Units. The incumbent… more
- Kemper (Doral, FL)
- …investigations of insurance claims referred to and accepted for investigation by the Special Investigative Unit . Our Special Investigator will function as ... and conducting and/or directing Examinations Under Oath. This investigator will coordinate investigations with outside SIU contacts, the Department of Insurance… more
- Humana (Oklahoma City, OK)
- **Become a part of our caring community and help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to ... the Oklahoma Medicaid Team. This team of Investigators conducts investigations into allegations of fraud, waste, and abuse involving...and other agencies such as the Medicaid Fraud Control Unit (MFCU) and coordinate all aspects of FWA activities… more
- Point32Health (Canton, MA)
- …motivated individuals to join our organization as a Fraud Operations Specialist within our Special Investigations Unit (" SIU "). The Fraud Operations ... Specialist is an essential team member of the SIU , responsible for developing and maintaining relationships with business units, vendors, law enforcement agencies,… 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 ... + Manage and coordinate cases being investigated by the SIU + Maintain all vendor cases + Assist with...Maintain all vendor cases + Assist with conducting complex investigations , including on-site investigations , review, complete and… more
- City of La Mesa, CA (La Mesa, CA)
- …patrol, field training officer, investigations , motor officer, school resource officer, special investigations unit , street team, honor guard and the ... and local traffic regulations; participates in and conducts a variety of criminal investigations ; provides support and assistance to special crime prevention and… more
- NJM Insurance (Trenton, NJ)
- …with Collections every 60-90 days for status; and assist GC Legal in reviewing the NJM Special Investigations Unit ( SIU ) fraud investigations . + ... using data provided from various sources including financial metrics databases, the NJM SIU , the GC Subrogation Department, GC Legal Staff, and GC Staff. + Review… more
- Travelers Insurance Company (Calabasas, CA)
- …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. as… more
- Travelers Insurance Company (Hoover, AL)
- …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. as… more
- Zurich NA (Schaumburg, IL)
- …Assist in the identification of fraudulent billings by reporting suspicious activity to Special Investigations Unit . + Resolve escalated issues by exercising ... or more years of experience in the Critical Care Unit or Emergency Room or Medical Surgical Facility or...or more years of experience in the Critical Care Unit or Emergency Room or Medical Surgical Facility or… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …as a liaison for activity generated by Customer Advocacy (CAU), Customer Service (CS), Special Investigations Unit ( SIU ), Provider Relations (PR), or ... Sales & Marketing. + Ensuring all regulatory requirements are being met, such as NYS DOH, CMS, NCQA, and HEDIS, serving as internal auditor within the group. + Responsible for all aspects of the Case Management department functions including quality,… more