SIU Manager - Healthcare Fraud, Waste & Abuse
Parkland Health and Hospital System (PHHS)
Parkland Health and Hospital System seeks a seasoned leader to manage the Special Investigations Unit (SIU), overseeing investigations into provider, member, and other healthcare fraud, waste, and abuse. You will ensure timely completion within regulatory and contractual requirements and guide SIU policy and procedures. The role requires extensive experience with healthcare compliance, regulatory agencies, and data-driven investigations, with a focus on protecting program integrity across Texas #J-18808-Ljbffr Parkland Health and Hospital System (PHHS)
- ...Community Health Plan seeks an experienced SIU Operations Manager to lead the Special Investigations... ..., and mitigation of suspected fraud, waste, and abuse within Texas Medicaid/CHIP programs... ...requires extensive knowledge of healthcare investigations, data analytics, and...Fraud
- ...PURPOSE Responsible for managing the operations of the Special Investigations Unit (SIU). Accountable for the investigation... ..., and other suspected fraud, waste, and abuse (FWA). Ensures SIU activities... ...: Bachelor's degree in Healthcare Administration, Business Administration...FraudFor subcontractorWork at office
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$125.9k - $188.86k
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...technology company advancing the diagnosis and management of coronary artery disease, the #1 cause... ...recognition for exceptional strides in healthcare innovation, is supported by medical... ....Heartflow has become aware of a fraud where unknown entities are posing as Heartflow...FraudLive inWork at officeLocal areaRemote workWorldwideRelocationRelocation package- ...that includes prevention, investigation and pursuit of fraud, waste, and abuse violations. The Clinical SIU Investigator ensures PCHP's accountability for... ...experience. Experience in provider education, a managed care organization or medical record auditing is preferred...FraudWork at office
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...Title: Health Homes Care ManagerDept: Care Management ServicesReports to: Health Homes... ...works collaboratively with participants, healthcare providers, community agencies, and support... ...service region.Ability to pass a Medicaid fraud background check.Ability to work occasional...FraudFull timeWork at officeImmediate startAfternoon shift- ...provision of comprehensive care within a managed care framework. Key... ...evidence-based medicine. Analyze healthcare provider data to create provider profiles... ...clinical components of programs addressing fraud, waste, and abuse within PCHP. Contribute to the formulation...FraudLocal area
$85k - $105k
...Healthcare Fraud InvestigatorCGS is seeking a Healthcare Fraud Investigator to provide legal... ....Analyze data for evidence of fraud, waste and abuse.Review and evaluate referrals to... ...in criminal justice, finance, project management, or other related field.Minimum three...FraudWork experience placementWork at officeLocal area$37.4k - $93.6k
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...caregiver and HCP needs in an evolving healthcare environment. This model is built around... ...” creates a unified focus among account management, medical, patient access and market access... ...com. Statement Regarding Job Recruiting Fraud Scams At Otsuka we take security and...FraudTemporary workLocal areaFlexible hours$50 per hour
The Project Manager, MedSurg Professional Services & Customer Success, serves as the primary... ...:Bachelor's degree in business, healthcare, information technology, engineering, clinical... ...a zero tolerance policy for candidate fraud. All information and credentials submitted...FraudRemote jobHourly payFull timePart timeWork at officeImmediate startWork from homeWorldwide$10k
...trusted by 600,000+ users across 50+ countries to eliminate waste, accelerate growth, and defeat fraud with industry-leading native AI. Great Place To Work... ...-sufficient operator: You proactively build pipeline, manage complex deals autonomously, and take ownership of your...FraudRemote work$30.5k - $43.5k
...Irving, TX, US, 75038 Summary At HMS, we make the healthcare system work better for everyone. We fight fraud, waste, and abuse so that people have access to the care they... ...could be a great fit. In this role, you’ll manage your own caseload from start to finish—researching...FraudFull timeContract workWork experience placementMonday to FridayFlexible hours- ...technical expertise in identity and access management, cybersecurity, cloud platforms, and... ...federation, consent, profile management, digital fraud controls, and identity lifecycle... ...social engineering, identity fraud, session abuse, and AI-enabled threats. Define service-level...FraudShift work
$20k - $100k
...and involve POCs, multiple stakeholders, managing trials, multi-faceted pricing negotiations... ...: One day you’ll meet with someone in waste management and the next you may be learning... ...Commitment to AuthenticityWe use Tofu, a fraud detection tool, to validate the authenticity...FraudFull timeRemote workFlexible hours$72.04k - $94.55k
...re hiring a Senior Analyst, SIU Investigator to join our SIU... .... You will analyze data and manage investigative caseload from... ...internal process improvements for Fraud Waste and Abuse (FWA) recoupments and... ...Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified...FraudFull timeRemote workWork from homeHome office- Job SummaryCOMPANY BACKGROUND:Tenet Healthcare Corporation (NYSE: THC) is a diversified... ...Solutions subsidiary provides revenue cycle management and value-based care services to... ...compliance with Stark, anti-kickback and other fraud and abuse laws, EMTALA, HIPAA, and any other...FraudWork at office
$120k - $140k
Switchboard is seeking a Customer Success Manager - Team Lead on behalf of our client, Yooz. This is a player/coach... ...trusted by 600,000+ users across 50+ countries to eliminate waste, accelerate growth, and defeat fraud with industry-leading native AI. Great Place To Work...FraudWork at officeRemote work- ...experience? At Vivmark Residential, we don't just manage properties; we pioneer exceptional living... ...(pools, spas, etc.), fitness equipment, waste management systems. Ability to understand... ...Notice.No Fees Notice & Recruitment Fraud Disclaimer:Vivmark Residential is aware...FraudWork experience placementLive inImmediate start
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- ...trust for a digital-first world. Today, impersonation, fraud, AI-driven scams, and identity abuse spread faster than any security team can respond to.... ...roadmap, ensuring Outtake remains the premier incident management and brand protection platform. Becoming an indispensable...FraudWork at officeImmediate startFlexible hours
$110k - $175k
...Medical is changing how it feels to work in healthcare.We’vereplaced profit-driven volume with... .... Lead a Sustainable Patient Panel:Manage a dedicated group of patients with full... ..., WellBe conducts monthly FACIS (Fraud and Abuse Control Information System) checks on all...FraudContract workLocal areaRelocationRelocation package- ...Route Manager Based in the Dallas-Fort Worth metroplex, Greenmark Waste Solutions ("Greenmark") is a locally-owned solid waste and recycling collection company. Greenmark serves industrial, commercial, and construction markets across the Dallas-Fort Worth metroplex...Temporary workLive outShift workDay shift
- ...peer to peer calls as necessary to support the utilization management process. ~ Provides clinical oversight for utilization... ..., and administration of the clinical aspects of PCHP fraud, waste and abuse programs. ~ Participates in development, implementation...FraudPermanent employmentLocumLocal areaRemote workWeekend work
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