- State of Massachusetts (Boston, MA)
- …seeking an experienced and dedicated individual to fill the role of Director for the Special Investigations Unit . In this role, the Director will be ... and monitoring all clinical and administrative operations of the Special Investigations Unit . This specialized...and regulations are known and practiced appropriately by all SIU staff. * Direct the monitoring and implementation of… more
- 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
- Prime Therapeutics (Salem, OR)
- …a purpose-driven career? Come build the future of pharmacy with us. **Job Posting Title** Special Investigations Unit ( SIU ) Investigator - Remote **Job ... Description** The Special Investigations Unit ( SIU ) Investigator is responsible for conducting standard investigations of potential pharmacy, member,… 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 Cigna Group (Bloomfield, CT)
- **Fraud Senior Advisor - Special Investigations Unit ( SIU ) Matter Resolution** Our organization is a leader in healthcare services, committed to ... of accountability and collaboration. **Position Overview** The Fraud Senior Advisor - Special Investigations Unit ( SIU ) Matter Resolution plays a… more
- CVS Health (Topeka, KS)
- …seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU ), dedicated to a specific self-funded plan ... sponsor. In this role, you will manage complex investigations into suspected and known acts of healthcare fraud,...abuse (FWA). **Key Responsibilities** + Conduct high level, complex investigations of known or suspected acts of healthcare fraud,… 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 (St. Paul, MN)
- …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
- Humana (Dayton, OH)
- …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 ... to encourage sensible and culturally-competent business standards + Oversee internal investigations of FWA compliance issues + Work with the Contract Compliance… more
- CVS Health (Harrisburg, PA)
- …position can be work from home anywhere in the United States. **Position Summary** The Special Investigations Unit ( SIU ) is looking for an analytically ... and reviewing incoming referrals and leads to determine if additional investigations are warranted. **Key Responsibilities** + Identify, research, analyze and… more
- Allied Universal (Provo, UT)
- …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
- 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
- CVS Health (San Antonio, TX)
- …Health Care Anti-Fraud Association (AHFI) * Experience In Medicaid Compliance, Medicaid Investigations , TX MCO Medicaid FWA Unit * Experience with Interpreting ... each and every day. **Position Summary** Direct oversight of SIU and Fraud, Waste and Abuse activities related to...Leads the team in the planning and execution of investigations of acts of healthcare fraud and abuse by… more
- State of Minnesota (Minneapolis, MN)
- …MDE-administered programs. This position provides executive leadership and oversight of both the Special Investigations Unit ( SIU ), which investigates ... students and families. Duties will include: * Provide strategic oversight of SIU and SMP investigations , including reviewing findings, identifying trends, and… 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
- 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
- Banco Popular Puerto Rico (San Juan, PR)
- …The Special Investigations Manager is responsible for overseeing the Special Investigations unit , which handles inquiries into customer claims, ... areas. + Foster a culture of integrity, accountability, and continuous improvement. Special Investigations & Audit Collaboration + Oversee investigations … 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
- Centene Corporation (Jefferson City, MO)
- …reporting of instances of potential fraud, waste and abuse no within scope of the Special Investigations Unit . + Prepare periodic reports and, as necessary, ... the continental United States. **Position Purpose:** The VP Corporate Compliance Investigations is responsible for the initial assessment of internal allegations and… more