- Stony Brook University (Stony Brook, NY)
- …University's Renaissance School of Medicine (RSOM) is seeking applications for a clinical pathology faculty member at the Assistant, Associate, or Full Professor ... (Clinician Educator track) to provide laboratory director oversight for the clinical microbiology laboratory section of the Stony Brook University Hospital's… more
- Stony Brook University (Stony Brook, NY)
- …of Psychiatry at the Renaissance School of Medicine is seeking an investigator with expertise in the development, validation, and implementation of AI applications ... developmental trajectories. Stony Brook University maintains a broad range of pre- clinical and clinical research cores, including fMRI, PET, ECT,… more
- Centene Corporation (Tallahassee, FL)
- …practices + Consult investigators to identify abuse and fraud by utilizing clinical and coding expertise to analyze patterns in billing activities + Performs ... LPC, LCSW, LMHC, PT, OT or ST license and 2+ years of related clinical experience in the field of obtained license. Experience in provider education preferred.… more
- Providence (Oakland, CA)
- **Description** ** Investigator External Audit Special Investigations Unit \*Remote The SIU Audit Investigator supports the compliance related activities ... of the Special Investigations Unit (SIU) at the Health Plan. This role...activities at the Health Plan. This includes the identification, investigation and correction of fraudulent and/or abusive billing and… more
- AmeriHealth Caritas (Columbus, OH)
- …Accountabilities:** + Ensures compliance with all requirements related to Special Investigation Units and fraud, waste and abuse investigations . + Conducts ... administrative services. Discover more about us at www.amerihealthcaritas.com. The Investigator is responsible for conducting comprehensive investigations of… more
- MVP Health Care (Rochester, NY)
- …innovative thinking and continuous improvement. To achieve this, we're looking for a ** Clinical Investigator ** to join #TeamMVP. This is the opportunity for you ... if you have a passion for problem solving and investigations , commitment to compliance and ethical standards and dedication...experience involving economic or insurance related matters. + A clinical investigator must have in addition to… more
- Sanford Health (Fargo, ND)
- …analytics, investigation , claim auditing and other areas related to Special Investigations . Completes reports of investigative findings and recommends ... investigation /audit. Master's Degree preferred Accredited Health Care Fraud Investigator (AHFI) certification or Certified Fraud Examiner (CFE) preferred Nursing… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …of the SIU Management, this position is responsible for the accurate and thorough clinical investigation of potential fraud, waste and abuse (FWA) for all lines ... Operations) and supporting systems. (BREADTH). + Expertise in complex clinical coding/reviewing assignments, difficult investigations and highly visible… more
- Molina Healthcare (Milwaukee, WI)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... records to document relevant findings of a post pay clinical review. This position manages documents and prioritizes case...experience working in a FWA / SIU or Fraud investigations + Thorough knowledge of PC based software including… more
- Constructive Partnerships Unlimited (Manhattan, NY)
- …Job Brief Assists the Incident Management Investigator with conducting investigations into ... to include supportive housing. POSITION DUTIES:1. Assists the Incident Management Investigator with conducting investigations into situations that may violate… more
- Point32Health (Canton, MA)
- … Investigator I is an essential team member of the Special Investigation Init (SIU ( Special Investigations Unit)) responsible for leading complex ... address the investigative findings and prevent future loss. The Investigator works closely with other members of the SIU...doing (top five): + Lead straightforward and moderately complex investigations in specified areas of Fraud Waste and Abuse.… more
- Blue KC (Kansas City, MO)
- …program** **Job Description Summary:** As part of Blue KC's Special Investigations Unit (SIU), the Fraud Investigator conducts reviews to identify potential ... to identify trends, patterns, outliers relative to peers and clinical standards, etc. In conjunction with the Manager and/or...policies and procedures. May work with Manager and/or Senior Investigator on larger, more complex, investigations . +… 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 ... join the Oklahoma Medicaid Team. This team of Investigators conducts investigations into allegations of fraud, waste, and abuse involving providers who submit claims… more
- University of Utah (Salt Lake City, UT)
- …+ Established track record of research accomplishments with a focus on clinical investigation and/or health services research + Eligibility for licensure ... Position Information **Position/Rank** General Internal Medicine Clinician Investigator **Department** 00232 - General Internal Medicine **City** Salt Lake City, UT… more
- US Capitol Police (Washington, DC)
- …of the ID; Prepare and disseminate written reports including reports of investigation , various investigative assessments, and investigations bulletins; Perform a ... mitigation, Member protection, and enforcement strategies. Specialty Units include Investigations , Intelligence and Interagency Coordination, and Dignitary Protection. A… more
- Health Care Service Corporation (Richardson, TX)
- …Coordination with all departments involved in each case required such as special investigations , customer service, pass, network management, marketing, case ... your professional development. **Job Summary** This position is responsible for performing clinical , billing, coding and lowest cost setting reviews for services pre… more
- US Capitol Police (Washington, DC)
- …of the ID; Prepare and disseminate written reports including reports of investigation , various investigative assessments, and investigations bulletins; Perform a ... risk mitigation, Member protection, and enforcement strategies. Specialty Units include Investigations and Dignitary Protection. A United States Capitol Police … more
- University of Pennsylvania (Philadelphia, PA)
- …members . Promote good clinical practice in the conduct of clinical investigations , included possessing an in-depth knowledge of the federal regulations ... members . Promote good clinical practice in the conduct of clinical investigations , included possessing an in-depth knowledge of the federal regulations… more
- University of Pennsylvania (Philadelphia, PA)
- …members + Promote good clinical practice in the conduct of clinical investigations , included possessing an in-depth knowledge of the federal regulations ... needed and monitor results. Responsible for study coordination for investigator -initiated studies, multi-center research studies, and patient-oriented clinical … more
- University of Pennsylvania (Philadelphia, PA)
- …and translational research projects. Job Description Job Responsibilities + Conduct clinical investigation utilizing GCP, which includes possessing and ... needed and monitor results. Responsible for study coordination for investigator -initiated studies, multi-center research studies, and patient-oriented clinical … more
