- CVS Health (Plantation, FL)
- …trends, and areas for improvement to senior management. **Required Qualifications:** . Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or ... equivalent certification . Minimum 8 years of healthcare experience, including 5 years of experience in medical coding . Proven experience in a leadership role, managing and mentoring a team of coding professionals preferred. . In-depth understanding of coding… more
- CVS Health (Harrisburg, PA)
- …innovate and deliver solutions to make health care more personal, convenient and affordable. The Special Investigations Unit is seeking a Manager to lead our ... team of Certified Professional Coders (CPC). The Manager is responsible for...for overseeing and managing coding reviews for fraud detection, investigation , and prevention efforts to safeguard the organization's resources… more
- State of Minnesota (Minneapolis, MN)
- **Working Title: Assistant Inspector General, Special Investigations Unit - State Prog Admin Manager Sr** **Job Class: State Program Administrator, Manager ... development opportunities. As the Assistant Inspector General over the Special Investigations Unit (SIU) in...to MDE during or at the conclusion of an investigation and/or prosecution, and any subsequent appeal. **Minimum Qualifications**… more
- Corewell Health (Grand Rapids, MI)
- Job Summary Responsible for planning, direction, and operation of the Special Investigations Unit (SIU). Responsible for developing and directing the fraud, ... + Responsible for the development, management, implementation and oversight of the Special Investigations Unit . Responsible for the overall direction,… 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, ... law enforcement agencies, regulatory bodies, and external partners during investigations . + Prepare comprehensive reports summarizing investigation outcomes,… more
- CareOregon (Portland, OR)
- …Oregon, Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Special Investigations Unit Investigator Department Health Share of ... - Flexible if in Central Time). Job Summary The Special Investigations Unit (SIU) Investigator...operational setting within a highly regulated industry. + FWA investigation experience in healthcare or with health insurance organization.… more
- CVS Health (Carson City, NV)
- …flexible to work EDT hours (8:00 am - 5 pm EDT) + Conducts investigations to effectively pursue the prevention, detection, investigation and prosecution of ... agencies as required by law and regulation. **Fundamental Components** + Conducts investigations of known or suspected acts of healthcare fraud, waste, and abuse… more
- Molina Healthcare (AZ)
- …to the SIU Manager. This position will be accountable for tracking on investigations conducted by his/her team and will provide oversight and guidance throughout the ... life of an investigation as well as QA reviews and approvals. In...effectively and timely. + Manage the flow of day-to-day investigations . + Perform assessment that QA measures were complete… more
- CVS Health (Trenton, NJ)
- …United States. We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU). In this role, you will ... manage complex investigations into suspected and known acts of healthcare fraud,...federal, state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud. + Demonstrates high… more
- US Secret Service (Washington, DC)
- …here. Responsibilities SPECIAL AGENTS During the course of their careers, Special Agents carry out assignments in both investigations and protection and ... Summary Joining the Secret Service as a Special Agent will allow you to perform critical...state or federal government or military emergency medical support unit Currently certified , licensed, or registered as… more