Partners with internal departments (e.g., Claims, Medical Management, Legal, Provider Relations) to implement corrective actions such as provider education, prepayment review, payment suspension, and overpayment recovery; manages corrective action and repayment plans and processes claims in SIU pend queues. POSITION SUMMARY: Operating under general direction from the SIU Director, the Clinical Investigator II serves as the Special Investigations Unit's clinical subject matter expert responsible for identifying, investigating, and preventing healthcare fraud, waste, and abuse (FWA).