- USAA (San Antonio, TX)
- …what truly makes us special and impactful. **The Opportunity** As a dedicated SIU case manager , within defined guidelines and framework you will evaluate ... and conclude claims identified by SIU Investigators as having elements of fraud or an...write reports and document activities and decisions in a case management system. + Proficiency in understanding the legal… 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 ... for you, we encourage you to apply! Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department… more
- USAA (New York, NY)
- …special and impactful. **The Opportunity** We are looking for a Manager , SIU ( Special Investigations Unit ) within P&C. Responsible for operational ... controls to mitigate fraud and other risks. + 4+ years of progressive experience within a Special Investigations Unit ( SIU ), with a proven track record… more
- Elevance Health (Mendota Heights, MN)
- …recover, eliminate and prevent unnecessary medical-expense spending. **Staff Vice President (VP), Special Investigations Unit ( SIU )** **Location:** May ... the national SIU . + Functions within the SIU include investigations , case intake...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Blue KC (Kansas City, MO)
- …assistance** **Employee discount program** **Job Description Summary:** As part of Blue KC's Special Investigations Unit ( SIU ), the Fraud Investigator ... Manager and/or Senior Investigator on larger, more complex, investigations . + Create and maintain detailed case files in accordance with SIU policies and… more
- CVS Health (Hartford, CT)
- …we do it all with heart, each and every day. The **Senior RFI Analyst** within the Special Investigations Unit ( SIU ) plays a key role in supporting ... fraud, waste, and abuse investigations by managing and responding to Requests for Information...The analyst will also provide **leadership support** to the Manager by assisting with team coordination, reporting, and strategic… more
- CVS Health (Phoenix, AZ)
- …parties including CVS Health corporate security, pharmacy audit and network teams, the client's special investigations unit ( SIU ), and Federal, State, ... the legal system and experience working in medical, pharmaceutical, legal and/or criminal investigations to develop and submit fraud case referrals to the client… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …encourage you to apply! Job Description: Summary: Under the guidance of the SIU Management, this position is responsible for the accurate and thorough clinical ... compliance and regulatory requirements. Primary activities include substantiating referrals, case planning and research, conducting onsite or desk audits, clinical… more
- The Robison Group (Columbus, OH)
- …WITHIN THE COMPANY INCLUDE: SIU work, Field Supervisor, Field Operations Manager , Case Management, etc. Department Surveillance Employment Type Part time ... Individuals selected for the position will be expected to perform investigations of workers compensation claims, liability investigations , multi-line insurance… more
- Travelers Insurance Company (Washington, DC)
- …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,… more
- Travelers Insurance Company (Louisville, KY)
- …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,… more
- TD Bank (New York, NY)
- …**Job Description:** Our TD Securities Compliance team is seeking a VP Compliance Manager for the brand new Trade Surveillance Quality Assurance team to develop and ... build out a global Surveillance QA program. The Surveillance Quality Assurance Manager will contribute to and help lead a specialized function responsible for… more
- Molina Healthcare (Louisville, KY)
- …accountability for compliance by overseeing, follow-up and resolution of investigations . **KNOWLEDGE/SKILLS/ABILITIES** + Provides oversight and review of the ... SIU referral intake and investigation process while giving guidance and direction to team on case investigation steps and actions. + Works with leadership to… more
- CVS Health (Cheyenne, WY)
- …Health Care Anti-Fraud Association (AHFI) + Experience In Medicaid Compliance, Medicaid Investigations , MCO Medicaid FWA Unit in the following States: **Texas, ... Leads a team in the planning and execution of investigations of acts of healthcare fraud and abuse by...to take in a timely and effective manner. Conducts case reviews and provides feedback to investigators on completeness… more