NewSurveillance Investigator Frasco IncSurveillance InvestigatorDes Moines, IA$22–$26 / hourCheck out our YouTube channel to learn more about what a day-in-the-life of a surveillance investigator at Frasco looks like: Frasco, Inc | YouTube Channel . Minimum Auto Insurance Coverage: $100,000 per person, $300,000 per accident bodily injury, and $50,000 property damage.
Iowa Clinical Investigator Consultant - Must Reside In Iowa Sun Life FinancialIowa Clinical Investigator Consultant - Must Reside In IowaDes Moines, IA$54,100–$81,200 / yearThrough employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. The Clinical Investigator will conduct in-depth analysis, peer analysis trend analysis and statistical analysis to identify providers whose utilization patterns are outside of the expected norm from their peers in their assigned markets.
Archaeology Principal Investigator - Project Manager Bolton & MenkArchaeology Principal Investigator - Project ManagerDes Moines, IowaIn this role, you will manage multiple projects, overseeing archaeological surveys and site evaluations, ensuring project planning and completion, maintaining client relationships, and serving as primary agency liaison. Today, Bolton & Menk has more than 1,000 employees throughout more than 35 locations in Minnesota, Iowa, North Dakota, North Carolina, South Carolina, and Colorado providing services to more than 400 communities and agencies.
Program Integrity Investigator (Healthcare Fraud Waste & Abuse) TriWest Healthcare AllianceProgram Integrity Investigator (Healthcare Fraud Waste & Abuse)Des Moines, IARemoteFull 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 TriWest Healthcare AllianceProgram Integrity InvestigatorDes Moines, IARemoteFull 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 InvestigatorIA$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.
Clinical Investigator Behavioral Health Centene Corporation GroupClinical Investigator Behavioral HealthIA$56,200–$101,000 / yearPosition requires the associate to verify authorization for services and written documentation of services provided against claim information, ensure the appropriateness and accuracy of diagnosis and procedure codes supporting such claims, coordinate medical necessity and appropriate level of care determinations with Medical Directors, and validate services against CMS and State-specific coverage, limitations and exclusion guidelines. 3+ years of providing direct Psychotherapy or Inpatient group therapy within inpatient psychiatric hospitals or units, residential treatment centers, substance abuse rehabilitation facilities, military or veteran hospitals.