Special Investigations Unit Director jobs in California
Special Investigations Unit Director oversees the operations for conducting thorough investigations. Develops the strategies for the cross-functional detection and elimination of fraudulent behavior. Being a Special Investigations Unit Director prepares investigative reports and analyses that pertinent to evidence obtained during investigations. May coordinate with outside sources such as law enforcement agencies, and external audit, etc. Requires a bachelor's degree. Additionally, Special Investigations Unit Director typically reports to top management. The Special Investigations Unit Director manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a Special Investigations Unit Director typically requires 5 years experience in the related area as an individual contributor. 1 - 3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)
Recently Added Special Investigations Unit Director jobs
- Inland Empire Health Plan
-
Rancho Cucamonga, CA
FULL_TIME
-
Overview
What you can expect!
Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!
Under general supervision, the Special Investigations Unit Medical Reviewer (SIU Medical Reviewer) performs reviews of medical records and healthcare claims to substantiate or refute the accuracy and compliance with federal and state regulations and contractual requirements of codes billed to identify coding errors and billing discrepancies in relation to incidents of suspected healthcare fraud, waste, and abuse (FWA) reported to IEHP’s Compliance Special Investigations Unit (SIU).
Additional Benefits
Perks
IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.
- CalPERS retirement
- 457(b) option with a contribution match
- Generous paid time off- vacation, holidays, sick
- State of the art fitness center on-site
- Medical Insurance with Dental and Vision
- Paid life insurance for employees with additional options
- Short-term, and long-term disability options
- Pet care insurance
- Flexible Spending Account – Health Care/Childcare
- Wellness programs that promote a healthy work-life balance
- Career advancement opportunities and professional development
- Competitive salary with annual merit increase
- Team bonus opportunities
Qualifications
Education & Experience
- A minimum of two (2) years of experience performing medical reviews of medical records and claims in a healthcare setting
- Bachelor’s degree in medical billing or medical coding, nursing, healthcare administration, or other related field from an accredited institution required
- Certified Professional Coder (CPC) required
- One of the following licenses preferred
- Possession of an active, unrestricted, and unencumbered Vocational Nurse (LVN) license issued by the California Board of Vocational Nursing and Psychiatric Technicians
- Possession of an active, unrestricted, and unencumbered Registered Nurse (RN) license issued by the California BRN
Key Qualifications
- Strong verbal and written communication, interpersonal skills, critical problem-solving skills, and attention to detail
- Above average proficiency in the use of technology applications, particularly Excel, Word, and others as necessary
Start your journey towards a thriving future with IEHP and apply TODAY!
Work Model Location
Hybrid
Pay Range
USD $34.14 - USD $39.57 /Hr. - 11 Days Ago
- Berkshire Hathaway Homestate Companies
-
Sacramento, CA
OTHER
- WHO WE ARE Berkshire Hathaway Homestate Companies is dedicated to being the best workers compensation insurance company by providing compassionate care to injured workers, superior service to our cust...
- 10 Days Ago
- Berkshire Hathaway Homestate Companies
-
Walnut Creek, CA
OTHER
- WHO WE ARE Berkshire Hathaway Homestate Companies is dedicated to being the best workers compensation insurance company by providing compassionate care to injured workers, superior service to our cust...
- 10 Days Ago
- Berkshire Hathaway Homestate Companies
-
San Diego, CA
OTHER
- WHO WE ARE Berkshire Hathaway Homestate Companies is dedicated to being the best workers compensation insurance company by providing compassionate care to injured workers, superior service to our cust...
- 10 Days Ago
- Berkshire Hathaway Homestate Companies
-
Sacramento, CA
OTHER
- WHO WE ARE Berkshire Hathaway Homestate Companies is dedicated to being the best workers compensation insurance company by providing compassionate care to injured workers, superior service to our cust...
- 11 Days Ago
- Inland Empire Health Plan
-
Rancho Cucamonga, CA
FULL_TIME
- Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experien...
- 11 Days Ago
Special Investigations Unit Director jobs at Popular Companies
- Phaxis
-
Jersey City, NJ
- A global Financial Firm is looking to hire an experienced Cash Management / FX Ops Consultant to join their team in Jers...
- 5/31/2024 12:00:00 AM
- Confidential
-
Jersey City, NJ
- Cash Management - AVP Work Schedule: Hybrid (on-site 2 days a week) SUMMARY: Support and approves MGeB, Test Key and oth...
- 5/31/2024 12:00:00 AM
- Courtesy Nissan
-
Richardson, TX
- Used Car Sales Director Courtesy Nissan of Richardson is seeking an experienced, enthusiastic, self-motivated, and profe...
- 5/31/2024 12:00:00 AM
- Brigham & Women's Hospital(BWH)
-
Boston, MA
- The Men's Health: Aging and Metabolism Clinical Research Unit at Brigham and Women's Hospital conducts government and in...
- 5/31/2024 12:00:00 AM
- Robert Half
-
Atlanta, GA
- Robert Half HR Solutions is currently sourcing for a Contract Employee Relations/Investigation Director for our retail c...
- 5/30/2024 12:00:00 AM
- Phyton Talent Advisors
-
Jersey City, NJ
- Our Client, a Global Investment Bank, is seeking a Cash Management Associate in their Jersey City, NJ location. Responsi...
- 5/30/2024 12:00:00 AM
- Phaxis LLC
-
Jersey City, NJ
- Summary: Support and approves MGeB, Test Key and other payment request transactions for Corporate customers for Client B...
- 5/30/2024 12:00:00 AM
- Brigham and Women's Hospital
-
Boston, MA
- The Men's Health: Aging and Metabolism Clinical Research Unit at Brigham and Women's Hospital conducts government and in...
- 5/30/2024 12:00:00 AM