Top 19 Siu investigator Jobs in Missouri

Lead SIU Investigator
Centene —Missouri
- $70,100 - $126,200 a year
- Full-time
- Remote
- Master's degree
- High school diploma or GED
- Mentoring
- Paid holidays
- Health insurance
Investigator, Special Investigations Unit (Meritain Health)
CVS Health —Jefferson City, MO
- $46,988 - $122,400 a year
- Full-time
- Customer service
- Research
- Mid-level
- Health insurance
- Dental insurance
SIU Investigator (Part-Time)
VRC Investigations —St. Louis, MO
- $30 - $35 an hour
- Part-time
- Customer service
- 5 years
- Military
- Profit sharing
- Paid training
Quick Apply
Manager, Sales Investigations
Centene —Missouri
- $87,700 - $157,800 a year
- Full-time
- Remote
- High school diploma or GED
- Fair chance
- 1 year
- Paid holidays
- Health insurance
Missouri, St. Louis SIU Investigator PT
Insight Service Group (ISG) —St. Louis, MO
- $20 - $27 an hour
- Part-time
- Mid-level
- Driver's License
- Travel
Quick Apply
Surveillance Investigator
VRC Investigations —St. Louis, MO
- $25 - $30 an hour
- Clean driving record
- Military
- Computer literacy
- Profit sharing
- Paid training
Quick Apply
As Needed Field Investigator- Fredericktown, MO
J T Becker & Co Inc —Missouri
- Writing skills
- Mid-level
- Driver's License
- Flexible schedule
Quick Apply
As Needed Field Investigator- Kansas City, MO
J T Becker & Co Inc —Kansas City, MO
- Writing skills
- Mid-level
- Driver's License
- Flexible schedule
Quick Apply
As Needed Field Investigator- St. Louis, MO
J T Becker & Co Inc —St. Louis, MO
- Writing skills
- Mid-level
- Driver's License
- Flexible schedule
Quick Apply
As Needed Field Investigator- Columbia, MO
J T Becker & Co Inc —Columbia, MO
- Writing skills
- Mid-level
- Driver's License
- Flexible schedule
Quick Apply
As Needed Field Investigator- Springfield, MO
J T Becker & Co Inc —Springfield, MO
- Writing skills
- Mid-level
- Driver's License
- Flexible schedule
Quick Apply
Surveillance Investigator
Allied Universal® Compliance and Investigations —Springfield, MO
- From $23 an hour
- Weekends as needed
- Microsoft Word
- Military
- Mid-level
- AD&D insurance
- Paid holidays
Quick Apply
2d
As Needed Field Investigator- Warrensburg, MO
J T Becker & Co Inc —Warrensburg, MO
- Writing skills
- Mid-level
- Driver's License
- Flexible schedule
Quick Apply
Surveillance Investigator - Part Time
Allied Universal® Compliance and Investigations —Springfield, MO
- $20 - $25 an hour
- Part-time
- Microsoft Word
- Military
- Mid-level
- AD&D insurance
- Paid holidays
Quick Apply
2d

Discover related jobs

Based on your search for siu investigator jobs.

Corporate Ethics & Compliance Investigator
Centene —Missouri
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time…
$107,700 - $199,300 a year
Lead SIU Investigator
Centene —Missouri
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time…
$70,100 - $126,200 a year

Show more related jobs

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

Fraud and Abuse Investigator / CPC - Remote
Sentara Workforce Solutions, LLC —Columbus, OH
Keywords: Healthcare, Health Plan, Remote, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada,…
$25.60 - $42.67 an hour
Quick Apply
3d
Investigator, Special Investigations Unit (Meritain Health)
CVS Health —Columbus, OH
The SIU Investigator will conduct investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover…
$46,988 - $122,400 a year

Show more jobs in cities nearby

I want to receive the latest job alert for siu investigator in missouri

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

siu investigator jobs near missouri

Surveillance Investigator jobs in St. Louis, MO

Investigations Manager jobs in Missouri

Siu Investigator jobs in St. Louis, MO

Field Investigator jobs in St. Louis, MO

Insurance Investigator jobs in Michigan

Surveillance Investigator jobs in San Francisco, CA

Surveillance Investigator jobs in Anchorage, AK

Surveillance Investigator jobs in Florida

Surveillance Investigator jobs in Fort Worth, TX

District Attorney Investigator jobs in California

Post Market Surveillance jobs in Remote

Veteran Military Program Project Manager jobs in Remote

Investigations Manager jobs in Washington, DC

Investigations Manager jobs in Saint Paul, MN

Training Manager jobs in New York, NY

Investigations Manager jobs in New York State

Office Manager jobs in Fort Collins, CO

Health Unit Coordinator jobs in Surprise, AZ

Health Unit Coordinator jobs in Fort Atkinson, WI

Health Unit Coordinator jobs in Cape Coral, FL

Lead SIU Investigator

Centene -
Missouri

Apply Now

Job Details

Full-time
$70,100 - $126,200 a year

Benefits

Paid holidays
Health insurance
401(k)
Tuition reimbursement
Paid time off

Qualifications

Healthcare financial misconduct investigations
Investigations regulatory compliance
Medicare
Medical law
Managed care
Managed care organization experience
Health insurance policy knowledge
Regulatory legal research
Medicare regulations
Insurance investigations
Centers for Medicare & Medicaid Services (CMS) billing regulations
Medicaid regulations
Medicaid

Full Job Description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

*This is a remote role anywhere within the continental US.*

Position Purpose: Position acts as a subject matter expert in the field of Special Investigations Unit (SIU) investigations. Provides direction and guidance to staff who investigate and remediate compliance and fraud, waste, and abuse related matters; while maintaining an investigative workload of moderate to high complexity. Assists manager on monitoring team caseload and report on metrics.

Provides guidance to team members who investigate and remediate compliance and fraud, waste, and abuse related matters.
Assists manager on monitoring team caseload and report on metrics.
Identifies training needs and develop training aids and step actions.
Provides training and mentoring to team on casework and other SIU activities.
Evaluates and assesses allegations to determine those criteria, including federal and state regulations, Centers for Medicare & Medicaid Services (“CMS”) guidelines, and internal policies, procedures, and standards that are alleged to have been violated.
Conducts and documents interviews investigatory purposes.
Reviews investigative interviews prepared by junior investigators.
Manages caseloads of moderate to high complexity, develops investigative plans for multiple investigations, prioritizing and managing through execution.
Thoroughly documents actions, organizes, and reviews case files.
Consults with management, in-house counsel, and/or senior leadership to resolve difficult or complex issues.
Identifies risks and recommends and communicates remedial actions to mitigate future potential risks.
Performs follow up to ensure remedial and disciplinary measures are implemented appropriately and timely.
Prepares clear and concise investigative plans and reports.
Provides support and guidance to junior investigative staff.
Identifies trends and aberrant activity to generate proactive leads for investigations and analyzes data to detect potentially fraudulent activity.
Attends, actively participates in, and/or leads meetings with various business area managers.
Communicates directly with Federal or State regulators.
Prepares cases for referral to management, government agencies, and law enforcement.
Develops and maintains strong working relationships with associates and regulators.
Testifies in criminal and civil matters.
Participates in and lead special projects as needed.
Performs other duties as assigned.
Complies with all policies and standards.

Education/Experience:

Bachelor's Degree in related field; or Associate's degree with 6 years related experience; or High School Diploma/GED with 7 years related experience. required.
Master's Degree preferred.
5+ years Healthcare fraud-related investigations with audit and risk analysis required.
1+ years Managed care or working with health insurance company required.
In-depth knowledge of government programs, the managed care industry, Medicare, Medicate laws and requirements, federal, state, civil and criminal statutes required.
Reading, analyzing and interpreting State and Federal laws, rules and regulations. Knowledge of community, state and federal laws and resources required.
Knowledge and understanding of managed care claims processing systems and medical claims coding preferred preferred.

Licenses/Certifications:

Accredited Health Care Fraud Investigator (AHFI), Certified Fraud Examiner (CFE) or other industry related certification preferred.

Pay Range: $70,100.00 - $126,200.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Apply Now

Refine Your Search

siu investigator jobs in missouri

Lead SIU Investigator

Investigator, Special Investigations Unit (Meritain Health)

SIU Investigator (Part-Time)

Manager, Sales Investigations

Missouri, St. Louis SIU Investigator PT

Surveillance Investigator

As Needed Field Investigator- Fredericktown, MO

As Needed Field Investigator- Kansas City, MO

As Needed Field Investigator- St. Louis, MO

As Needed Field Investigator- Columbia, MO

As Needed Field Investigator- Springfield, MO

Surveillance Investigator

As Needed Field Investigator- Warrensburg, MO

Surveillance Investigator - Part Time

Discover related jobs

Explore jobs in cities nearby

I want to receive the latest job alert for siu investigator in missouri

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected