Remote SIU Audit & Clinical Lead
Blue Cross and Blue Shield of North Carolina
- Remote job
Blue Cross NC is seeking a Special Investigations Unit (SIU) Manager of Audit/Clinical to lead a team of clinicians and coders focused on detecting, preventing, and correcting healthcare fraud, waste, and abuse. You will ensure accurate documentation and billing while supporting the SIU's mission to protect members and communities. You will drive strategy with internal/external partners, advance AI-powered analytics, and guide pre/post-payment review workflows. #J-18808-Ljbffr Blue Cross and Blue Shield of North Carolina
- Blue Cross NC seeks a SIU Manager of Audit/Clinical to lead a team of clinicians and coders focused on detecting, preventing, and correcting health care... ...accurate documentation and billing while guiding a remote workforce and collaborating with regulators, providers,...Remote work
- Blue Cross NC is seeking a Special Investigations Unit (SIU) Manager of Audit/Clinical to lead a team of clinicians and coders focused on detecting, preventing... ...while supporting SIU's mission. The position emphasizes remote leadership, collaboration with internal and external...Remote work
- Blue Cross NC is seeking a Special Investigations Unit (SIU) Manager of Audit/Clinical to lead a team of clinicians and coders focused on detecting, preventing, and correcting health care fraud, waste, and abuse. This role ensures patient care is accurately documented...Remote job
- Blue Cross NC is seeking a Special Investigations Unit (SIU) Manager of Audit/Clinical to lead a team of clinicians and coders focused on detecting, preventing... ...internal stakeholders. This role supports a Hybrid-Flex/Remote Flex work model with national (US) opportunities,...Remote jobFlexible hours
- Abacus Insights is seeking a Complex Clinical Audit (CCA) Business Solutions Lead with 5+ years in payment integrity to translate payer needs into scalable product logic. You’ll work with AI Engineering on backend build, demo capabilities to major payers, and shape how...Remote job
- Blue Cross NC is seeking a strategic SIU Manager of Audit/Clinical to lead a team of clinicians and coders focused on detecting, preventing, and correcting... ...to strengthen investigations. The position offers remote leadership for a hybrid workforce, opportunities to collaborate...Remote work
- Blue Cross NC is hiring a Special Investigations Unit (SIU) Manager of Audit/Clinical to guide a team of clinicians and coders in detecting, preventing... ...stakeholders. The position emphasizes leadership of a remote workforce, leveraging AI/tools to improve efficiency, and...Remote job
- Blue Cross NC is seeking an SIU Manager of Audit/Clinical to lead a team of clinicians and coders focused on detecting health care fraud, waste, and abuse... .... A clinical perspective and leadership in a hybrid/remote setting are essential for success in this role. #J-1880...Remote job
- Blue Cross NC is seeking a Special Investigations Unit (SIU) Manager of Audit/Clinical to lead a team of clinicians and coders focused on detecting, preventing... .... This senior role requires strong leadership for a remote workforce, collaboration with regulators and providers,...Remote work
- Blue Cross NC seeks a seasoned SIU Manager of Audit/Clinical to lead clinicians and coders in detecting, preventing, and correcting health care fraud,... ...documentation and billing practices. The role emphasizes remote leadership, collaboration with stakeholders, and...Remote jobFlexible hours
$98k - $126.5k
Job DescriptionThe Claims Supervisor, SIU will oversee the operation of a unit of SIU Investigators and Analysts with varying levels... ...Essential Duties and Responsibilities:Direct and control the work of remote SIU Investigators and Analysts.Establish and monitor unit goals...Remote workWork at office- Blue Cross NC is seeking an SIU Manager of Audit/Clinical to lead clinicians and coders in detecting and preventing health care fraud, waste, and abuse... ...accurate documentation and billing. You will manage a remote workforce, develop strategies with internal and external...Remote work
$107.9k - $172.64k
...Blue Cross NC is hiring a Special Investigations Unit (SIU) Manager of Audit/Clinical to lead a team of clinicians and coders focused on detecting, preventing... .... Provide engaging, effective leadership for a remote workforce, including coaching, feedback, and professional...Remote workWork at officeLocal areaFlexible hours2 days per week$104.97k - $131.21k
...from Home) Position Description As the Clinical Informatics Lead, you will be responsible for... ...Education Specialist- Midwest/ West- Remote- ( AZ, IL, MN, WI) Minneapolis, MN $86... ...Clinical Account Specialist, TherOx Chicago SIU Specialist - Remote in the California...Remote workFull timeWork experience placementWork at officeWork from home- Oscar Health Insurance is seeking a Senior Analyst, SIU Clinical Investigator to detect and audit aberrant billing patterns in claims and clinical documentation... ...files for potential recovery or referrals. This is a remote role with NYC/Tempe office options. #J-18808-Ljbffr...Remote jobWork at office
$89.6k - $149.3k
...Overview THIS ROLE WILL BE HYBRID (4 DAYS/WEEK) ONSITE AND 1 DAY REMOTE BASED OUT OF: BUFFALO NY, WILMINGTON DE, or BRIDGEPORT CT.... ...BE WITHIN A COMMUTABLE DISTANCE OR WILLING TO RELOCATE. Leads and executes audits across their assigned domain, overseeing annual risk...Remote workWork experience placementLocal areaRelocation$93.1k - $232.8k
Job Posting Title- Clinical Trial LeadLocation: Home-based in the U.S. Responsibilities & Key Tasks• Lead global, cross-functional trial teams to ensure successful delivery... ...logical and organized approach to execution#LI-Remote#LI-NITINMAHAJANIQVIA is a leading global...Remote workFull timePart timeLocal areaImmediate startWork from homeWorldwide- ...efficiently navigate the complex world of clinical trials to bring life-changing therapies... ...(CTL) to join our A-team (office-based*/remote). As a CTL at Allucent, you are providing... ...and Project Manager and other functional leads to ensure clinical monitoring deliverables...Remote workFull timeContract workWork at officeFlexible hours2 days per week
$108.8k - $202k
The PositionAs a Clinical Research Engagement Lead (CREL) at Roche, you will act as the ultimate strategic partner and primary face of Roche Clinical... ...strategic landscaping and site engagement (in-person or remote) during the protocol concept and study set-up phases to identify...Remote workFull timeLocal areaRelocation package- ...a highly motivated and detailed-oriented Clinical Research Coordinator to provide study coordination... ...*The Clinical Research Coordinator Lead is responsible for coordinating their... ...WorkPositions that are eligible for hybrid or mobile/remote work mode are at the discretion of the...Remote workTraineeshipWork at office
- 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 jobWork from home
- Emerald Clinical Trials in the United States is building a network of experienced Clinical Leads / Clinical Trial Managers for upcoming opportunities. This home-based role would oversee global and regional studies, with a strong preference for candidates with experience...Remote jobWork from home
$177k - $278.08k
...empower you to shine? Join us as a Director, Quantitative Clinical Pharmacology Lead in our Cambridge, MA office.At Takeda, we are transforming... ...classified as “ hybrid” in accordance with Takeda’s Hybrid and Remote Work policy.Empowering Our People to ShineDiscover more at...Remote workMinimum wageTemporary workWork experience placementWork at officeLocal area- 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 jobWork from home
$137k - $200k
...the Director of Special Investigative Unit (SIU) provides strategic leadership for... ...all Property & Casualty claim operations.Lead the Special Investigative Unit and oversee... ...Underwriting, Legal, Compliance, Internal Audit, and law enforcement to improve investigative...Shift work$130k - $160k
Emerald Clinical in the United States is seeking an experienced Clinical Lead to manage global clinical trials. The role offers flexibility through home-based work and requires strong project leadership skills, clinical operations knowledge, and experience in managing clinical...Remote jobWork from home- ...Health, the HCC Documentation Lead (RN), while incorporating the... ...clinicians who are a part of our Clinically Integrated Network (CIN), Yale... ...reviews and assists with audits of documentation for quality and... ...forms of communication. Primarily remote position, however occasional...Remote workFlexible hours
- Emerald Clinical Trials is seeking experienced Clinical Leads / Clinical Trial Managers for future opportunities in the United States. This home-based role oversees global and regional studies, with preference for candidates who have renal, oncology, cardiometabolic or...Remote jobWork from home
- ...candidates who can work onsite at either location Strong remote candidates may be considered, particularly those with significant... ...Position Overview Client is seeking experienced Clinical Development Trial Leads (CDTLs) to support global oncology clinical trials across...Remote work
- ...To lead the clinical development of biopharmaceutical research programs, the full-time Global Medical Lead in Northbrook, IL will oversee clinical trials, design development plans, and collaborate with cross-functional teams while supporting gene therapy initiatives. Key...Remote workFull time
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