- Centene Corporation (Frankfort, KY)
- …Position acts as a subject matter expert for the Contractor's Program Integrity unit to reduce Fraud, Waste and Abuse of Medicaid services within Kentucky. Provides ... to Department requests for information + Serve as a lead for the Kentucky market + Manage and coordinate...+ Manage and coordinate cases being investigated by the SIU + Maintain all vendor cases + Assist with… more
- Molina Healthcare (Covington, KY)
- **JOB DESCRIPTION** **Job Summary** Under direct supervision of the Manager, SIU , the Team Lead is responsible to lead a small team of investigators and ... on daily investigative activities as a back-up to the SIU Manager. This position will be accountable for tracking...Manager. This position will be accountable for tracking on investigations conducted by his/her team and will provide oversight… more
- AmeriHealth Caritas (Columbus, OH)
- …commensurate with position requirements in lieu of formal educational requirements for the Lead SIU Investigator position may be considered. + Valid ... investigations . + Performs necessary functions to support all aspects of SIU investigations and responsibilities to include, but not limited to: Intake;… more
- Elevance Health (Costa Mesa, CA)
- …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
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** The AVP Special Investigations Unit ( SIU ) is responsible for overseeing and managing fraud, waste, and abuse (FWA) detection, ... assets and reduce healthcare costs. This requires demonstrating vision in positioning the SIU with the right skill sets, cutting edge analytics tools, and robust… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The role of the Special Investigations Unit ( SIU ) Investigator is to assist in the reduction and recuperation ... timely, effective and result in an overall achievement of unit goals. + Investigator researches and analyzes...assigned by management to meet the needs of the Special Investigations Unit . **SUPERVISORY RESPONSIBILITY:**… more