- Elevance Health (Seattle, WA)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU ** **Location:** This role enables associates to work ... questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other internal areas on matters of mutual concern.… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …OMIG's minimum investigator requirements as follows: Persons employed by the SIU as investigators shall be qualified by education or experience, which shall ... addition to Level I Accountabilities) + Performs more complex investigations with less direct supervision. Performs compliance and/or governance...criminal justice or related field; or employment as an investigator in the SIU on or before… more
- Elevance Health (Indianapolis, IN)
- …law. **Position Overview:** Responsible for providing leadership and guidance to the Special Investigations Unit **Pharmacy** team in investigating, ... with the administration and operational activities occurring within the Special Investigations Unit for **pharmacy...research findings + Provides guidance to investigators and other SIU staff in the development of criminal and recovery… more
- MVP Health Care (Tarrytown, NY)
- …limited to MD or RN . + New York State Nursing license required ( RN preferred). Experience in health insurance fraud investigations preferred. + Obtain CPC ... improvement. To achieve this, we're looking for a **Clinical Investigator ** to join #TeamMVP. This is the opportunity for...if you have a passion for problem solving and investigations , commitment to compliance and ethical standards and dedication… more