Job Category: Claims Services Job Description: HealthPartners is hiring a Payment Integrity/SIU Technical..., attends meetings and assumes projects as assigned by supervisor, manager or director. REQUIRED QUALIFICATIONS: * Bachelor...
Job Category: Claims Services Job Description: HealthPartners is hiring a Payment Integrity/SIU Technical..., attends meetings and assumes projects as assigned by supervisor, manager or director. REQUIRED QUALIFICATIONS: * Bachelor...
Job Category: Claims Services Job Description: HealthPartners is hiring a Payment Integrity/SIU Technical..., attends meetings and assumes projects as assigned by supervisor, manager or director. REQUIRED QUALIFICATIONS: * Bachelor...
and ensure all Californians have equitable access for their health care needs. The Promise Health Plan Medical Director... will report to the Promise Health Plan Senior Medical Director, Utilization Management. The Promise Health Plan Medical Director...
We are adding to our Auto Claims Leadership Team! The Auto Property Damage Director is responsible for oversight... approvals over adjuster authority and the transfer of files to appropriate areas (SIU, Litigation, Total Loss, Subrogation...
We are adding to our Auto Claims Leadership Team! The Auto Property Damage Director is responsible for oversight... approvals over adjuster authority and the transfer of files to appropriate areas (SIU, Litigation, Total Loss, Subrogation...
We are adding to our Auto Claims Leadership Team! The Auto Property Damage Director is responsible for oversight... approvals over adjuster authority and the transfer of files to appropriate areas (SIU, Litigation, Total Loss, Subrogation...
Position Summary We are seeking an experienced Delivery Manager/Director to oversee the successful execution..., and Operations leaders, the Delivery Manager/Director will manage project execution, resource allocation, risk mitigation...
Litigation Unit Complex Claims Consulting Director. This is an individual contributor role responsible for the direct handling... or SIU resources for further investigation. Achieves quality standards by effectively managing each claim to ensure...
that is responsible for all customer service functions and quality control of the final investigative SIU product. The Senior Director... claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators...
across multiple business segments. Align SIU strategy with enterprise objectives, regulatory expectations, and emerging industry..., accountability, and transparency for the SIU organization. Enhance employee engagement, strengthen culture, and foster a sense...
across multiple business segments. Align SIU strategy with enterprise objectives, regulatory expectations, and emerging industry..., accountability, and transparency for the SIU organization. Enhance employee engagement, strengthen culture, and foster a sense...
and trends in order to advise the Director of Legal Operations on emerging or potential fraud, waste, and abuse issues across the... preferred Minimum of six (6) years of experience in the healthcare industry within a Special Investigations Unit (SIU...
of the claim and making referrals to appropriate Claim, Recovery or SIU resources for further investigation. Achieves... additional duties as assigned. Reporting Relationship Typically Director or above Skills, Knowledge & Abilities Thorough...
training needs and works with SIU Director on development plans for team members. Develops and maintains close working...
Claim, Recovery or SIU resources for further investigation. Achieves quality standards by appropriately managing each claim.... Reporting Relationship Typically Director or above Skills, Knowledge & Abilities Thorough knowledge of the commercial...
Claim, Recovery or SIU resources for further investigation. Achieves quality standards by appropriately managing each claim.... Reporting Relationship Typically Director or above Skills, Knowledge & Abilities Thorough knowledge of the commercial...
, Special Investigations Unit (SIU), Clinical, Networks) and the PBM Program Integrity team to address identified claims payment... inaccuracies, quantify financial impact, and ensure timely submission of high-quality case leads to the SIU.. Independently...
operations. Triage and refer cases or inquiries to other BSC compliance resources (e.g., Privacy Office, SIU, Employee Relations... per month (for roles below Director-level) or once per week (for Director-level roles and above). Exceptions: o Member-facing...