Entry Level Background Investigator (Midwest Region) - TOP SECRET CLEARANCE REQUIRED CACI International IncEntry Level Background Investigator (Midwest Region) - TOP SECRET CLEARANCE REQUIREDSioux Falls, SDRecognizes or uses correct English grammar, punctuation, and spelling; communicates information (for example, facts, ideas, or messages) in a succinct and organized manner; produces written information, which may include technical material that is appropriate for the intended audience. The pay and benefits provided for this position will meet or exceed the minimum required amounts detailed in the wage determination issued by the Department of Labor and made applicable to this position, as incorporated into CACI's government contract for the work location.
Contract Investigator - Ft. Campbell, TN OMNIPLEX World Services Corporation, A Constellis CompanyContract Investigator - Ft. Campbell, TNCampbell, TennesseeWork hours vary depending on availability of leads and do not always fall within normal business hours, to include potential weekend hours or third-shift appointments. We are a trusted provider of high quality background investigations programs to Department of Homeland Security (DHS) and the intelligence community at locations throughout the United States.
Principal Investigator – Cultural Resources / Archaeology System OnePrincipal Investigator – Cultural Resources / ArchaeologyPierre, South DakotaThis role is ideal for a seasoned cultural resource professional who can provide leadership, ensure regulatory compliance, and support collaborative field teams working on meaningful projects across the Northern Plains. Work collaboratively with Traditional Cultural Specialists and Tribal Historic Preservation Office (THPO) representatives to ensure culturally sensitive resources are properly recorded and respected.
Medicaid FANS Investigator South Dakota State GovernmentMedicaid FANS InvestigatorPierre, SD$31–$33.50 / hourThe Ideal Candidate Will Have: Bachelor's degree from an accredited four-year college or university; be a certified law enforcement officer in the State of South Dakota; minimum of three years of criminal or law enforcement experience; special consideration will be given to applicants with a background in healthcare, law enforcement, accounting, or auditing. This critical work focuses on protecting patients in healthcare settings - including nursing homes, hospitals, and pharmacies - where fraud deprives them of quality care and wastes public resources.
Surveillance Investigator Allied UniversalSurveillance InvestigatorSioux Falls, South DakotaThe Surveillance Investigator will perform discreet mobile and stationary surveillance of a Claimant to confirm current activities and capabilities to assist with the administration of an insurance claim. Conduct independent investigations of insurance claims across a range of coverage types, including workers’ compensation, general liability, property and casualty, and disability .
Surveillance Investigator - Part Time Allied UniversalSurveillance Investigator - Part TimeSioux Falls, South DakotaThe Surveillance Investigator will perform discreet mobile and stationary surveillance of a Claimant to confirm current activities and capabilities to assist with the administration of an insurance claim. Conduct independent investigations of insurance claims across a range of coverage types, including workers’ compensation, general liability, property and casualty, and disability .
Program Integrity Investigator TriWest Healthcare AllianceProgram Integrity InvestigatorSioux Falls, SDRemoteFull timeComplies with the Veterans Affairs Community Care Network (CCN) and TRICARE T-5 contracts; DHA and TRICARE program guidelines and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, Military members and family (as warranted), providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals. The PI Investigator t is responsible for the identification, analysis, case development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA), the Healthcare Finance Administration (HCFA) and the Department of Defense, Defense Health Agency for the TRICARE program; requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).
Program Integrity Investigator (Healthcare Fraud Waste & Abuse) TriWest Healthcare AllianceProgram Integrity Investigator (Healthcare Fraud Waste & Abuse)Sioux Falls, SDRemoteFull timeComplies with the Veterans Affairs Community Care Network (CCN) and TRICARE T-5 contracts; DHA and TRICARE program guidelines and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, Military members and family (as warranted), providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals. The PI Investigator t is responsible for the identification, analysis, case development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA), the Healthcare Finance Administration (HCFA) and the Department of Defense, Defense Health Agency for the TRICARE program; requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).
Senior Compliance Investigator Centene Corporation GroupSenior Compliance InvestigatorSD$70,100–$126,200 / yearLeads and conducts compliance and ethics investigations across all business units and health plans, including but not limited to assessment of allegations, review of relevant documents, witness interviews, analysis of facts, root cause analysis, and preparation of investigation reports with recommended remedial or disciplinary actions. Education/Experience: A Bachelor's Degree in Related Field or Associates with 5 years of applicable experience, or a High School/GED with 6 years of applicable experience may substitute for the Bachelor's Degree, required.