- City of New York (New York, NY)
- …with all regulatory and procedural guidelines. Maintain and update status and statistical reports of unit 's case review activities and output of work on a ... date. In partnership with the Intake/Borough Office Units, conducts case management review , investigation , and...improve productivity. Maintains monthly and annual statistical reports of unit 's case review performance for… more
- State of Colorado (Denver, CO)
- Investigations Unit Manager (Hybrid) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4997906) Apply Investigations Unit Manager ... notary providers, and licensed durable medical equipment companies. The Investigations Unit exercises statutory authority under the... Unit by providing coaching and guidance to unit employees, and assigning case work while… more
- CVS Health (Jefferson City, MO)
- … Unit (SIU)! **Position Summary** The SIU Investigator conducts investigations to effectively pursue the prevention, investigation and prosecution of ... - Researches and prepares cases for clinical and legal review . - Documents all appropriate case activity...in identifying resources and best course of action on investigations . - Cooperates with federal, state, and local law… more
- Centene Corporation (Austin, TX)
- … Review post-payment cases with appropriate parties to obtain refund + Provide case updates on progress of investigations and coordinate with Health Plans on ... the Continental US. Ideal candidate has strong background in healthcare fraud investigations and Accredited Health Care Fraud Investigator or a Certified Fraud… more
- State of Massachusetts (Springfield, MA)
- …The MCAD is seeking motivated and experienced individuals to Supervise the Employment Investigations Unit . Incumbent in this position will perform investigative ... case load and complete a minimum requirement of investigations each month. Incumbent in this position will also...provide on the job training for employees in their unit ; review and analyze investigative dispositions prepared… more
- City of New York (New York, NY)
- …of social services. - Review and assign case records to unit staff. Coordinate the workflow of investigations by providing technical assistance to all ... FRAUD INVESTIGATOR CIVIL SERVICE TITLE. The Bureau of Fraud Investigation (BFI) is mandated to detect and deter Public...and provide investigative information. - Maintain control on all case records assigned to the unit . Prepare… more
- MTA (New York, NY)
- Senior Director, Diversity and Equal Opportunity (DEO) Investigations Job ID: 11878 Business Unit : MTA Headquarters Location: New York, NY, United States ... Deputy Chief Diversity and Inclusion Officer/ EO (DCDIO), the Senior Director Investigations will manage staff responsible for investigation of allegations of… more
- The Walt Disney Company (Glendale, CA)
- …Investigations Manager within Global Security Investigations . The Global Security Investigations Team is a 24/7 response unit supporting the Global ... a part of the team that conducts research and investigations that protect the people, assets, and brand of...and relevance of online information. + Experience with standard case management systems, including entering and maintaining case… more
- Bank of America (Richmond, VA)
- Operations Analyst - TFX Investigations - Global Payment Operations Richmond, Virginia **To proceed with your application, you must be at least 18 years of age.** ... be at least 18 years of age.** Acknowledge (https://ghr.wd1.myworkdayjobs.com/Lateral-US/job/Richmond/Operations-Analyst Global-Payment-Operations- Investigations \_25028926) **Job Description:** At Bank of America, we are… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …completing a variety of different tasks supporting clinical operations including the Physician Review Unit , Case Management and Utilization Management. Some ... clinical staff, including Care Management, Utilization Management, and the Physician Review Unit .The Operational Support Specialist has responsibilities that… more
- Travelers Insurance Company (Irvine, CA)
- …through a continuous process of management involvement and frequent claim file review and extensive litigation management. Serve as a field representative for the ... service quality and streamlined processes to add value for our customers. + Review new notices, ensuring claims are assigned to staff with appropriate skill sets.… more
- Molina Healthcare (St. Petersburg, FL)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation , ... regulatory requirements. + Interacts with regulatory and/or law enforcement agencies regarding case investigations . + Prepares audit results letters to providers… more
- City of New York (New York, NY)
- …guidelines of the grant. This person would be exclusively assigned to the Forensic Sciences Unit Cold Case team which would allow for a focused investigator to ... be invested throughout long-term investigations . JOB RESPONSIBILITIES: -Conduct thorough and professional ...assigned -Mentor and assist junior investigators when appropriate -Continuing case management and review -Provide on-going status… more
- Indian Health Service (Gallup, NM)
- …support/direct care services that the patient will need in coordination with service unit case managers and discharge planners, to include tribal entities when ... Center in Gallup, NM. The primary responsibilities involve providing clinical case management support to the Purchased/Referred Care Program, coordinating healthcare… more
- City of New York (New York, NY)
- …- Under the guidance of the Division Director, conduct research on relevant case law and legal statutes. Review and interpret investigative policies to ... ASSOCIATE FRAUD INVESTIGATOR CIVIL SERVICE TITLE. Bureau of Fraud Investigation (BFI) is mandated to detect and deter Public...and deter Public Assistance fraud and misuse by conducting investigations of individuals and groups that attempt to or… more
- City of New York (New York, NY)
- …within required timeframes - Provide on-going training and guidance to all casework staff in unit to ensure that all case practice requirements are met - Assist ... consultation - Maintain accurate count of subordinates' caseload - Maintain accurate unit coverage during vacations - Arrange/conduct case conferences when… more
- Indian Health Service (Pine Ridge, SD)
- …in the Specialty Clinic Department. The incumbent is responsible for meeting established Unit Standards of Nursing Practice. Case Management is performed to ... the Specialty Clinic Department at the Pine Ridge Service Unit , Pine Ridge, SD. The position performs the primary...when needed. Makes rounds of patient care areas to review charts for appropriateness, completeness, and timeline of documentation… more
- State of Connecticut, Department of Administrative Services (Norwich, CT)
- Developmental Services Supervisor Of Case Management Hybrid Recruitment # 250723-0578FP-001 Location Norwich, CT Date Opened 7/24/2025 12:00:00 AM Salary $90,516 - ... take this opportunity to consider the Developmental Services Supervisor of Case Management position! The State of Connecticut (https://portal.ct.gov/) , Department… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …for activity generated by Customer Advocacy (CAU), Customer Service (CS), Special Investigations Unit (SIU), Provider Relations (PR), or Sales & Marketing. ... Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for… more
- City of New York (New York, NY)
- …CLERICAL ASSOCIATE CIVIL SERVICE EXAM WHEN IT BECOMES AVAILABLE. Bureau of Fraud Investigation (BFI) is mandated to conduct investigations of individuals and ... one (1) Clerical Associate III to function as a Unit Clerk, who will: - Enter specific case...IREA internal database systems. Update previous information and retrieve case information when requested. - Review information… more