Hybrid-Remote SIU Manager - Healthcare Fraud Investigations
Blue Cross NC
- Remote job
Blue Cross NC is seeking a Special Investigations Unit (SIU) Manager of Investigations to lead a multi-state team focused on identifying, preventing, and addressing health care fraud, waste, and abuse. You will oversee case inventory, guide investigative action plans, and provide strategic direction to ensure thorough investigations from intake to resolution. You’ll bring a Bachelor's degree (or 10+ years in related field), AHFI or CFE certification, and 8+ years of experience in healthcare #J-18808-Ljbffr Blue Cross NC
- VRC Investigations seeks experienced SIU investigators to support multi-line insurance fraud investigations. Work from home options are available with a hybrid model and travel within the advertised city and state is required. You will interview insureds and witnesses,...Remote jobFraudWork from home
- Blue Cross NC is seeking a seasoned SIU Manager of Operations to lead investigations into health care fraud, waste, and abuse. You will oversee intake, triage... ...performance metrics, and regulatory compliance. Hybrid work with remote flexibility is available. #J-18808-Ljbffr...Remote workFraudFlexible hours
$107.9k - $172.64k
...is hiring a Special Investigations Unit (SIU) Manager of Operations to lead... ...correct health care fraud, waste, and abuse... ...interpretation of complex healthcare claims data to... ...Where You'll Work Our Hybrid Flex approach is built... ...flexibility to work remotely with intentional in-...Remote workFraudWork at officeLocal areaFlexible hours2 days per week$107.9k - $172.64k
...is hiring a Special Investigations Unit (SIU) Manager of Audit/Clinical to... ...correcting health care fraud, waste, and abuse.... ...leadership for a remote workforce, including... ...interpretation of complex healthcare claims data to... ...Where You'll Work Our Hybrid Flex approach is built...Remote workFraudWork at officeLocal areaFlexible hours2 days per week- Healthcare Fraud Shield is seeking a Clinical Coder/Fraud Investigator to join our SIU team at headquarters. You will analyze medical records, abstract CPT/HCPCS/ICD-10 codes,... ...detail and the ability to work independently. Remote work eligibility is available. #J-18808-...Remote jobFraud
$107.9k - $172.64k
...is hiring a Special Investigations Unit (SIU) Manager of Investigations to... ...addressing health care fraud, waste, and abuse.... ...conducting/leading healthcare fraud investigations... ...Where You’ll Work Our Hybrid Flex approach is... ...flexibility to work remotely with intentional in‑...Remote workFraudWork at officeLocal areaFlexible hours2 days per week$28.1 - $42.15 per hour
...40 hours / Days Hybrid or Remote Join a mission‑driven... ...integrity in healthcare claims, this is... ...Internal Audit and the Fraud, Waste and Abuse... ...) Committee for investigations and provider... ...and ensures the SIU processes and procedures... ..., and database management. Maintain...Remote workFraudDaily paidFull timeTemporary workFlexible hours- ...is seeking a seasoned Health Care Fraud Investigator to support a remote SIU team across the continental US. You... .... The role requires 5+ years in healthcare fraud investigations, knowledge of... ...government programs, and the ability to manage complex caseloads. This position...Remote jobFraudFlexible hours
$60k - $87.4k
...Description This job is responsible for investigating and analyzing complex, multi-... ...to the special investigation unit (SIU) for potential fraud. This role typically handles a... ...Quotit, HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star Marketing...Remote workFraudContract workWork at officeWork from homeVisa sponsorshipWork visa$62.1k - $92.7k
...consumers. Job Description As a SIU Field Investigator responsibilities include investigating suspected fraud, conducting detailed case... ...judgment, and the ability to manage high-impact cases from start... ..., HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star...Remote workFraudContract workWork at officeWork from homeVisa sponsorshipWork visa- SIU Clinical Investigator Department: SIU Employment Type: Full Time Location... ...Headquarters Description Healthcare Fraud Shield, a leader in... ...discretion and secure information management. Certificate/License:... ...development initiatives Remote work eligible REMOTE WORK...Remote workFraudFull timeFlexible hours
- ...UnitedHealth Group in Omaha, Nebraska, seeks an investigator to assess fraud and misconduct allegations. You will conduct investigations, analyze data, and ensure compliance with regulations while collaborating with internal and external partners. The ideal candidate...Remote workFraud
- A leading company in healthcare fraud prevention is seeking a talented Coder or Clinical Coder/Fraud Investigator. This full-time role involves analyzing patient medical records... ...compliance with coding guidelines. The position is remote work eligible, requiring a CPC...Remote workFraudFull time
- ...Cross NC is seeking a strategic SIU Manager of Audit/Clinical to lead a... ..., preventing, and correcting healthcare fraud, waste, and abuse. The role... ...uses analytics to strengthen investigations. The position offers remote leadership for a hybrid workforce, opportunities to collaborate...Remote workFraud
- ...Estágios e Treinamentos seeks a Medicaid Fraud Investigator to join its Special Investigations Unit. This role focuses on identifying healthcare fraud, conducting audits, data analysis... ...skills, and MS Office proficiency. Remote work from the Chicago area is preferred...Remote jobFraud
- Centene Corporation in Georgia is seeking an experienced investigator to independently lead complex fraud, waste, and abuse investigations across providers,... ...to identify risks, develop case strategies, and manage resolutions in line with laws and policies. The role...Remote jobFraud
$87.7k - $157.8k
...and optimization of SIU capabilities that support... ..., prevention, and investigation of fraud, waste, and abuse (... ..., and priorities. Manages, mentor, and develop... ...involving healthcare fraud analytics, including... ...approach to work with remote, hybrid, field or office work...Remote workFraudFull timePart timeWork at officeFlexible hours- The SIU Investigator role at Cambia Health Solutions focuses on fraud and abuse investigations, audits and education. You will analyze data, interview subjects, and... ...funds and prevent future incidents. Working in a hybrid environment, you’ll train other investigators, maintain...Fraud
- Premera Blue Cross is hiring an Investigator III in our Hybrid SIU team. You will lead medium to high complexity fraud cases from start to finish, analyze claims data, and coordinate... ...enforcement as needed. The role requires healthcare fraud investigation experience, strong...Fraud
- Loyalty MGA LLC is seeking a SIU Investigator to identify and investigate potential fraudulent claims. The role supports fraud prevention and requires collaboration with internal teams. A hybrid work schedule is available after probation. The ideal candidate has strong...FraudTrial period
- ...MGA in Miami, FL is hiring an SIU Investigator to identify and investigate... ...claims. The role offers a hybrid schedule after probation and... ...evidence collection to support fraud prevention. You will analyze... ..., and present findings to management and regulators while collaborating...FraudTrial period
- The SIU Investigator will conduct field as well as desk investigations of insurance claims referred to and accepted for investigation by the Special Investigative Unit. This remote investigator will work from home and service the Miami-Dade County and surrounding areas...Remote jobFraudWork from home
$135k - $145k
...021 by mission-aligned healthcare leaders and organizations... ...As our Enrollment RN Manager, you’ll be the clinical... ...requirements. In this hybrid role, you’ll split your... ...based on local markets; remote roles are aligned to national... .... Beware of Scams and Fraud Please beware of scams...Remote workFraudTemporary workPart timeWork at officeLocal areaMonday to FridayFlexible hours$78.9k
...helping our customers manage risk with laser-... ...position can be remote anywhere in the United... ...an experienced investigator to join our... ...Investigations Unit (SIU). SIU is responsible... ...deterring insurance fraud committed against... ...remotely and/or with a hybrid in-office/remote...Remote workFraudWork at officeFlexible hours$70.1k - $126.2k
...flexibility. This is a remote role anywhere... ...members who investigate and remediate compliance and fraud, waste, and... ...matters. Assists manager on monitoring... ...and other SIU activities. Evaluates... .... 5+ years Healthcare fraud-related investigations... ...with remote, hybrid, field or...Remote workFraudFull timePart timeWork at officeFlexible hours- ...Corporation is seeking a senior leader to direct SIU analytics, detection, and investigative analytics across healthcare programs. You will work with SIU leadership and... ...role requires 5+ years in healthcare analytics, fraud detection, SIU operations, and leadership of analytics...Remote jobFraud
$100k - $125k
...Quality & Safety Manager Daymark Health... ...interventions and a hybrid in-person + virtual... ...Venture Fund, and Healthcare Foundry. Be... ...cautious of recruitment fraud, and always... ...audits, incident investigations, and root-cause analysis... ...role is fully remote but will require regular...Remote workFraudFlexible hours- National General, part of The Allstate Corporation, is seeking an experienced SIU Investigator to join our team. This territory covers Northern Louisiana and Mississippi, with a strong preference for candidates located near Monroe, LA. Candidates residing in Monroe, Shreveport...Remote jobFraud
- Kemper Corporation in Dallas, TX is seeking a SIU Investigator to conduct field and desk investigations of insurance claims. This remote role supports the Downers Grove area with... ...agencies, and prepare formal reports for fraud investigations. The role requires knowledge...Remote jobFraud
- ...Associate Project Manager - Emerging BioPharma IQVIA... ...-based, office-based, hybrid options available... ...materials at Kick Off and Investigator meetings. Monitor... ...commercial insights and healthcare intelligence to the... ...policy for candidate fraud. All information and credentials...Remote workFraudWork at officeImmediate startWork from homeWorldwide
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