Pharmacy SIU Lead Investigator - Remote/Hybrid
Centene Corporation
New York, NY
- Remote job
Centene Corporation in Georgia is seeking an experienced investigator to independently lead complex fraud, waste, and abuse investigations across providers, members, pharmacies, and vendors. You will analyze claims data, medical records, and financial information to identify risks, develop case strategies, and manage resolutions in line with laws and policies. The role requires strong investigative experience, ability to coordinate with Compliance, Legal, and government partners, and skill in #J-18808-Ljbffr Centene Corporation
Vacancy posted 5 days ago
Similar jobs that could be interesting for youBased on the Pharmacy SIU Lead Investigator - Remote/Hybrid in New York, NY vacancy
$70.1k - $126.2k
...flexibility. This is a remote role anywhere within... ...guidance to team members who investigate and remediate... ...on casework and other SIU activities. Evaluates... ...to generate proactive leads for investigations and... ...approach to work with remote, hybrid, field or office work schedules...Remote workFull timePart timeWork at officeFlexible hours- 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
- Centene Corp. is seeking a Senior Pharmacy SIU Investigator to independently lead complex fraud, waste, and abuse investigations across providers, members, pharmacies, and vendors. You will use analytics, records review, and interviews to uncover misconduct and support...Remote job
$70.1k - $126.2k
...flexibility. Position Purpose Independently leads complex fraud, waste, and abuse (FWA) investigations involving providers, members, pharmacies, vendors, and other entities utilizing... ...and a flexible approach to work with remote, hybrid, field or office work schedules....Remote workFull timePart timeWork at officeFlexible hours$78.9k
...(C&F) provides market leading property & casualty, accident... ...position can be remote anywhere in the United... ...seeking an experienced investigator to join our Special Investigations Unit (SIU). SIU is responsible for... ...remotely and/or with a hybrid in-office/remote presence...Remote workWork at officeFlexible hours$7,716 - $10,074 per month
Caltrans is seeking a Supervising Special Investigator I in Sacramento County. The role is permanent, full-time with hybrid telework. It reports to the Independent Office of Audits and Investigations (IOAI) and leads a team of investigators and support staff. The position...Remote workPermanent employmentFull timeWork at office- Veracity Research Company in Atlanta, GA currently seeks experienced SIU investigators to deter and combat insurance fraud. Positions include work-from-home, part-time and full-time hourly roles, with a hybrid structure requiring travel within the city and state. You will...Hourly payFull timePart timeWork from home
- Centene Corporation is seeking a seasoned investigator to independently lead complex fraud, waste, and abuse investigations across providers, members, and other entities. You will analyze diverse data sources, develop investigative strategies, and manage cases through...Remote job
- Elevance Health is seeking an Investigator II for Carelon Payment Integrity SIU in Atlanta, GA. The role emphasizes identifying... ...facility, professional, and pharmacy claims, and collaborating with law... ...required. The position supports a hybrid work model with in-office presence...Work at office2 days per week1 day per week
- Cambia is seeking an SIU Investigator II/III to join its team across multiple offices in the western US. The role blends analytical review,... ...healthcare payments. Travel and on-site audits are possible, with a hybrid office expectation. The candidate should have a related...Work at office
- 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...Trial period
- Loyalty MGA in Miami, FL is hiring an SIU Investigator to identify and investigate potential fraudulent claims. The role offers a hybrid schedule after probation and requires conducting interviews, surveillance, and evidence collection to support fraud prevention. You...Trial period
- The SIU Investigator role at Cambia Health Solutions focuses on fraud and abuse investigations, audits and education. You will analyze data... ...recover misused funds and prevent future incidents. Working in a hybrid environment, you’ll train other investigators, maintain...
$86.8k - $198k
Employee Relations Investigator LeadThe Opportunity:We are seeking a highly skilled Lead Employee Relations Investigator to join our... ...their cameras on during meetings.Remote: If this position is listed as... ...Allen or customer facility.Hybrid: If this position is listed as...Remote workFull timeContract workPart timeWork at officeLocal area- ...FloridaDetailsKemper is one of the nation’s leading specialized insurers. Our success is a... ...on our promises. Position Summary:The SIU Investigator will conduct field as well as desk... ...Special Investigator will function as a remote investigator working from her/his residence...Remote workFull timeWork experience placementWork at office
$112.7k - $193.2k
...Caring. Connecting. Growing together. Job Description - Lead Technical Product Manager - Remote or Hybrid in MN or DC (2367143) Lead Technical Product Manager... ...health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their...Remote jobMinimum wageFull timeWork experience placementWork at officeLocal area- ...Seeking a seasoned SIU Investigator with health plan experience, the full-time position focuses on building and managing cases from intake to referral, ensuring compliance with regulatory standards while collaborating with various departments. Key responsibilities Conduct...Remote workFull time
Virtual Vocations Inc
United States4 days ago - AML RightSource is seeking an Experienced AML Investigator to detect and investigate suspicious financial activity and oversee quality control. The role may be remote or hybrid, with in-office options depending on client needs, and requires handling SARs and KYC compliance...Remote jobWork at office
- ...Origin is seeking an experienced SIU Investigator to join our growing team in Las Vegas, Nevada. This role is ideal for investigators with experience handling insurance fraud investigations, obtaining statements, and identifying indicators of fraudulent activity. We are...Remote work
Origin Investigations Inc.
United States4 days ago $56.2k - $101k
...Fraud Investigator You could be the one who changes everything for our 28 million members. Centene is transforming the health of... ...time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted...Remote workFull timePart timeWork at officeFlexible hoursCentene Corporation
United States4 days ago- ...Special Investigations Unit (Siu) Desk Investigator At AssuranceAmerica, we are more than a unique blend of insurance assets. We believe in creating a culture where every associate has the opportunity to learn and grow. We strive to create a work environment to meet...Remote workContract workWork at officeRelocation package
AssuranceAmerica
United States5 days ago $23.13 - $39.45 per hour
...Location(s) Glendale, California, Remote-CA Details Kemper is one of the nation's leading specialized insurers. Our... ...promises. The Special Investigator 1 will complete field and desk... ...from evidence that support our SIU and claims organization. This entry...Remote workWork at officeKemper
United States1 day ago- Healthcare Marketing Group, LLC is seeking a Pharmacy Relationship Manager to drive growth by educating pharmacy staff and providers about... ...field visits across the Phoenix metro area with partial remote work supported by comprehensive training and coaching. You will...Remote work
$25 - $29 per hour
...for an accommodation or an alternative application process. SIU Investigator Part Time Technical Las Vegas, NV, US 5 days ago Requisition... ...Surveillance, Claims Investigations, Net-Sweep Investigations, Remote Controlled Surveillance, and more, we’re able to save our clients...Remote workBi-weekly payHourly payPart timeWork at officeFlexible hoursAdvantage Surveillance
Las Vegas, NV2 days ago- ...Delhaize USA is seeking the Manager of Pharmacy Compliance Coordination to lead our controlled substance compliance... .... The position supports flexible/hybrid work with 3 in-person days at core... ..., PA; Scarborough, ME) and 2 remote days, reporting #J-18808-Ljbffr Ahold...Remote workFlexible hours
- 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
$30 per hour
...Workers Compensation/General Liability Premium Auditor - Field & Hybrid $30 Per Billable Hour base rate for audits conducted strictly... ...oriented Premium Auditor to join our growing team. This is a full-time remote position responsible for servicing the Philadelphia, PA...Remote workHourly payFull timeFor contractorsWork from homeHome officeFlexible hoursWeekend workAfternoon shift3 days per weekEarly shiftRLD Associates, Inc.
Philadelphia, PA19 hours ago$88.92k - $176.4k
A leading technology company in Washington, DC is seeking an experienced Insider Risk Investigator to enhance organizational security by investigating potential insider threats. The... ...investigation experience. This hybrid position requires working in-office three...Work at office3 days per week- ...Technologies in Chicago, IL, is seeking a skilled Trade Compliance Investigator to lead investigations into export controls, sanctions, and... ...reports to the Sr. Director of Investigations and works on a hybrid schedule across multiple cities including Chicago, IL. You will...
- Inova Health System in Virginia seeks a Sr. Clinical Pharmacist specializing in BiTE therapy to join a leading oncology program. This full-time role supports development and operations of the BiTE therapy program, providing clinical expertise, treatment planning, toxicity...Remote jobFull time
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Pharmacy SIU Lead Investigator - Remote/Hybrid. Be the first to apply!
Related searches
- clinical investigator New York, NY
- compliance investigator New York, NY
- defense investigator New York, NY
- opm background investigator New York, NY
- background investigator New York, NY
- healthcare investigator New York, NY
- corporate investigator New York, NY
- surveillance investigator New York, NY
- ethics investigator New York, NY
- legal investigator New York, NY