Director, Healthcare Fraud Investigations & SIU
Mass General Brigham Health Plan Holding Company, Inc.
Mass General Brigham Health Plan Holding Company, Inc. is looking for a Director for their Special Investigations Unit (SIU). This role requires a leader to manage investigations related to healthcare fraud, waste, and abuse while overseeing audit processes to ensure compliance with all regulations. The ideal candidate will have at least 5-7 years in insurance audits and a strong understanding of regulatory compliance. This hybrid position offers competitive salaries and opportunities for career advancement within a supportive team. #J-18808-Ljbffr Mass General Brigham Health Plan Holding Company, Inc.
- The Director, Special Investigations Unit (SIU) at Mass General Brigham Health Plan leads a team focused on preventing and detecting healthcare fraud, waste and abuse, with oversight of audits, referrals, and regulatory reporting. Hybrid role based in Assembly Row, Somerville...FraudFlexible hours
$124.34k - $225k
...an exciting place to be within the healthcare industry. As a member of Mass General... ...opportunities, and much more. The Director, Special Investigations Unit (SIU) will report to Sr. Vice President,... ...of money related to health care fraud, waste, and abuse. The SIU team will...FraudWork at officeLocal areaFlexible hours- CVS Health in Boston, MA is seeking an SIU Investigator to conduct investigations into healthcare fraud and abuse, pursue prevention and prosecution, and ensure compliance with federal and state regulations. The role requires 1-3 years of investigative experience and proficiency...FraudFull time
- ...Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are at... ...Functions Responsible for conducting confidential investigations of suspected fraud, waste & abuse (FWA) involving medical providers, plan members...FraudContract workWork at officeLocal areaFlexible hours
$43.89k - $93.57k
...and one community at a time. Position Summary The Special Investigations Unit (SIU) Investigator conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply with federal...FraudHourly payFull timeTemporary workLocal area- A national investigative services firm is seeking a meticulous and experienced SIU Investigator to conduct comprehensive investigations into potential fraud and misconduct. This role involves various investigative tasks such as analyzing incidents, obtaining witness statements...Fraud
- ISG is seeking a Part-Time SIU Investigator in Boston, MA to conduct in-depth investigations into fraud and misconduct. This role requires experience in insurance-related cases and proficiency in report writing. The ideal candidate will handle various investigative tasks...FraudPart time
- Insight Service Group (ISG) is looking for an experienced SIU Investigator to join their team in Boston, MA. This role involves conducting thorough investigations into potential fraud and misconduct, including gathering evidence, compiling reports, and engaging with witnesses...Fraud
- CVS Health is seeking an SIU Investigator for Meritain Health to support network cost management and anti-fraud efforts. You will conduct investigations, pursue prevention of fraud, and coordinate with federal, state, and local agencies to recover funds. The role requires...FraudFull timeLocal area
- About Us Insight Service Group (ISG) is a national investigative services firm specializing in cost containment and anti-fraud related services. We are dedicated to... ...our operations. Our Special Investigations Unit (SIU) plays a vital role in identifying and mitigating...Fraud
- Mass General Brigham Health Plan Holding Company, Inc. is seeking a Data Analyst to conduct confidential investigations of suspected fraud, waste and abuse, and to perform analytic reporting across claims and provider data. Hybrid role with on-site presence at Assembly...Fraud
- About Us:Insight Service Group (ISG) is a national investigative services firm specializing in cost containment and anti-fraud related services. We are dedicated to... ...our operations. Our Special Investigations Unit (SIU) plays a vital role in identifying and mitigating...FraudFor subcontractor
$70k - $150k
...Kroll’s North American Investigations, Diligence and Compliance - Specialist practice is seeking... ...financial forensics (CFF) or certified fraud examiner (CFE) designation is preferred... ...U.S.-specific benefits, which include: Healthcare Coverage: Comprehensive medical, dental...FraudTemporary workInterim roleFlexible hours- Jobtailor is seeking an investigator to generate new investigations and continue with ongoing civil actions involving fraud in areas such as healthcare, contracting, and grants, as well as other fraud and abuse of federal public funds and programs. The investigator will...Fraud
- CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project in Nashville, TN. The candidate must take the initiative to ask questions to successfully complete tasks, perform detailed work consistently, accurately, and under pressure...Fraud
- Jobtailor in Boston, MA is hiring an investigator to conduct complex criminal and civil investigations into Medicaid fraud and abuse. You will review complaints, access Medicaid claims, and develop investigative plans. The role requires strong analytical and communication...Fraud
$46.99k - $122.4k
...administrator of self‑insured commercial health plans. The SIU Investigator will support Meritain Health’s Network Cost Management team... ...effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply with state...FraudHourly payFull timeTemporary workWork experience placementWork at officeLocal areaFlexible hours- A leading government services provider is seeking a Healthcare Fraud Investigator to provide legal support for a government project. The ideal candidate will have a degree in criminal justice or a related field, with at least three years of relevant experience. Responsibilities...FraudFull timeWork at office
- The investigator will generate new investigations, and to continue with ongoing investigation and civil actions involving fraud in areas such as healthcare, contracting, and grants, as well as other fraud and abuse of federal public funds and programs. Regularly meets...FraudWork at office
$65k - $75k
...enhance the customer experience. The Senior Director, Private Aviation Solutions is a sales-... ...Health Reimbursement Arrangement (HRA) Healthcare Flexible Spending Account (HFSA)... ...Please be cautious of potential recruitment fraud. If you are interested in exploring opportunities...FraudFull timeWork at officeFlexible hours- Employment Type: Full-Time, Mid-Level Department: Litigation Support CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project in Nashville, TN. The candidate must take the initiative to ask questions to successfully complete...FraudFull timeWork experience placementWork at officeLocal area
- Financial Investigator Employment Type: Full-Time, Mid-Level Department: Financial Investigation Provide legal support... ...violations of federal law, including money laundering, wire fraud, mail fraud, bank fraud, healthcare fraud, procurement fraud, and other federal program...FraudFull timeInterim roleLocal areaFlexible hours
- The Commonwealth of Massachusetts is seeking candidates for the Investigator I / II / III roles in the Medicaid Fraud Division. The position involves conducting complex investigations into fraud and abuse allegations among Medicaid providers. Candidates must have a bachelor...Fraud
- ...contracts, and social media reviews, and documenting activities in concise reports. The ideal candidate will have 5-7 years of FWA investigation experience, strong data analysis skills, and the ability to translate complex topics for diverse #J-18808-Ljbffr Mass General...Fraud
$185k - $200k
...corporate deck and other presentations here. About the Role Associate Director, Clinical Supply Chain As the Associate Director of Clinical... ...for any fees related to unsolicited resumes. Thank you. Fraud Alert We are aware of employment scams where individuals pose as...FraudWork at officeFlexible hours$225k - $275k
...is seeking an experienced and strategic Director, Medical Writing to lead the... ...study protocols and protocol amendments Investigator’s Brochures (IBs) Clinical Study Reports... ...BA or BS in a relevant scientific or healthcare discipline; advanced degree preferred....Local area$204.4k - $379.6k
...Description Summary #LI-Hybrid Internal Title: Director Location: Cambridge, MA, USA Director... ...Deep expertise in toxicologic and/or investigative pathology, nonclinical toxicology study... ...Skills, Time Management Skills #J-18808-Ljbffr Healthcare Businesswomen’s AssociationFor contractors- Plymouth Rock Assurance seeks a Director of the Special Investigative Unit to lead enterprise fraud across Personal Lines P&C claims. You will drive prevention, detection... ...8-10+ years in P&C claims with 5-7+ years in SIU leadership and proficiency with Shift Technology....FraudShift work
$228k - $280k
Position Summary The Senior Director, Head of Toxicology will lead and build the toxicology... ...and strategic leadership across both investigative and regulatory toxicology, supporting a... ...Pioneering Medicines currently offers healthcare coverage, an annual incentive program,...$30 per hour
Join to apply for the Associate Director, Security role at Alnylam Pharmaceuticals Join to... ...property, physical security, investigations, information security (in partnership with... ...Protection Professional (CPP), Certified Fraud Examiner (CFE) and Physical Security Professional...Fraud16 hoursFull timeLocal areaRemote work
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