Job Closed
This listing is no longer active.
Devoted Health was founded in 2017 to provide seniors with healthcare plans and personalized health guides using world-class technology. On a mission to make healthcare easier, mor
SIU Investigator
Location
United States
Posted
67 days ago
Salary
$55K - $100K / year
Seniority
Mid Level
No structured requirement data.
Job Description
SIU Investigator
Devoted Health
Job Description A bit about this role: Are you a highly analytical and experienced investigator with a passion for uncovering the truth and protecting vital healthcare resources? Our Special Investigations Unit (SIU) is looking for a skilled Investigator to join our dedicated team. In this crucial role, you'll be at the forefront of preventing, detecting, and responding to healthcare fraud, waste, and abuse (FWA), safeguarding our members and the integrity of the Medicare Fund. If you're driven by meticulous investigation, data-driven insights, and a commitment to justice, we encourage you to apply. Responsibilities and Impact will include: As an SIU Investigator, you'll be responsible for the full lifecycle of complex FWA investigations, acting as a subject matter expert and collaborating with various stakeholders. Your key responsibilities will include: - Lead Complex Investigations: Plan, organize, and execute specialized investigations into allegations of healthcare fraud, waste, and abuse. This includes handling intricate cases requiring advanced investigative knowledge and skills. - Data-Driven Detection: Utilize advanced data mining and analysis techniques to identify aberrancies and outliers in claims, medical records, enrollment, and other healthcare transactions. You'll independently research FWA issues and employ cutting-edge investigative resources. - Expert Guidance: Serve as a subject matter expert for other SIU Investigators, providing specialized knowledge and guidance to elevate team capabilities. - Policy & Strategy Development: Contribute to the development of robust policies and procedures related to FWA detection and investigation, as well as the annual SIU risk assessment and work plan. - Thorough Documentation & Reporting: Conduct comprehensive FWA investigations, ensuring complete and accurate case documentation and detailed investigative reports that adhere to SIU policies and standards. - External Referrals & Collaboration: Prepare comprehensive summary and detailed reports on investigative findings for referral to federal and state agencies, ensuring full compliance with regulatory requirements. You'll also actively participate in OIG Healthcare Fraud Workgroups. - Stakeholder Engagement: Collaborate closely with internal stakeholders (e.g., FWA Monthly Workgroup, Market/Network, Credentialing Committee) to share updates on FWA schemes, coordinate recommendations, and facilitate fund recovery or other necessary actions. - Provider Education: Conduct impactful provider education sessions as a direct response to investigation findings and audits. - Liaison & Point of Contact: Serve as a key point of contact for corporate and field inquiries regarding FWA, and participate in meetings with providers, business partners, regulatory agencies, and law enforcement. - Training & Development: Assist in developing and presenting engaging FWA training programs for internal and external audiences. Required skills and experience: - Education: A Bachelor’s Degree in Business, Criminal Justice, Healthcare, or a related field, or equivalent relevant work experience. - Experience: - Minimum of 3 years of dedicated experience in health insurance fraud investigation. - Minimum of 5+ years experience as a detective or investigator for a law enforcement agency. - Proven experience within Medicare and/or Medicaid programs, specifically with medical claim billing, reimbursement, audit, or provider contracting. - Demonstrated experience with data analysis techniques. - Experience with the Healthcare Fraud Shield platform is a significant plus. - Exceptional Analytical Skills: Ability to interpret and dissect complex data sets, identifying patterns and anomalies indicative of FWA. Must have demonstrated experience with AI tools. - Outstanding Communication: Excellent written and verbal communication skills are essential for clear report writing, compelling presentations, and effective stakeholder engagement. - Integrity & Detail-Oriented: A strong commitment to integrity and compliance, coupled with meticulous attention to detail in all aspects of investigations. - Independent & Collaborative: Proven ability to work independently, manage a diverse caseload of investigations, and thrive in a fast-paced environment, while also excelling in collaborative team settings. - Strong Organizational Skills: Highly organized with the ability to manage multiple complex investigations simultaneously and effectively prioritize tasks. Desired skills and experience: - Certified Fraud Examiner (CFE) - Certified Professional Coder (CPC) #LI-DS1 #LI-Remote Salary range: $55,000 - $100,000 /year The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job. Our Total Rewards package includes: - Employer sponsored health, dental and vision plan with low or no premium - Generous paid time off - $100 monthly mobile or internet stipend - Stock options for all employees - Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles - Parental leave program - 401K program - And more.... *Our total rewards package is for full time employees only. Intern and Contract positions are not eligible. Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a diverse and vibrant workforce. At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States. And we've just started. So join us on this mission! Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business. As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.
Related Guides
Related Categories
Related Job Pages
More Security Analyst Jobs
Security Analyst (3rd Shift)
VectraVectra® is the leader in AI-driven threat detection and response for hybrid and multi-cloud enterprises. The Vectra AI Platform delivers integrated signal across public cloud, SaaS, identity, and data center networks in a single platform. Powered by patented Attack Signal Intelligence, it empowers security teams to rapidly prioritize, investigate and respond to the most advanced cyber-attacks. With 35 patents in AI-driven threat detection and the most vendor references in MITRE D3FEND, organizations worldwide rely on the Vectra AI to move at the speed and scale of hybrid attackers.
Vectra® is the leader in AI-driven threat detection and response for hybrid and multi-cloud enterprises. The Vectra AI Platform delivers integrated signal across public cloud, SaaS, identity, and data center networks in a single platform. Powered by patented Attack Signal Intelligence, it empowers security teams to rapidly prioritize, investigate and respond to the most advanced cyber-attacks. With 35 patents in AI-driven threat detection and the most vendor references in MITRE D3FEND, organizations worldwide rely on the Vectra AI to move at the speed and scale of hybrid attackers. For more information, visit www.vectra.ai. Location: Remote, United States This position works on a 4x10 3rd shift schedule Position Overview Vectra is seeking a highly skilled and experienced MDR (Managed Detection and Response) Senior Security Analyst to join our team. As a Security Analyst, you will serve in a critical role in protecting and defending Vectra MDR customer infrastructure. You will be responsible for monitoring and analyzing security events, responding to incidents, conducting SOC (Security Operations Center) operations, and assisting MDR customers to ensure their needs are met. A successful candidate will have sound technical experience and skills, blended with strong interpersonal, communication, and project management skills. Responsibilities - Monitor security logs and alerts from various sources, including intrusion detection systems, Endpoint Detection and Response (EDR) systems, and security information and event management (SIEM) tools. - Investigate and analyze security incidents, identify root cause, and develop appropriate mitigation strategies. - Execute security response actions, including full remote remediation of endpoints. - Perform threat hunting and proactive analysis to identify potential security risks and vulnerabilities. - Collaborate with cross-functional teams, including product, engineering, and support, to resolve customer incidents or issues. - Mentor and provide guidance to junior security analysts, sharing knowledge and best practices. - Conduct health checks and architecture reviews, providing technical expertise and real-life experience in creating solutions, designs, and recommendations. - Be a strong voice for your customers across business to identify new detection models, identify new product features, build content for both internal and external customer knowledge bases, and ensure successful Vectra deployments. - Travel expected 0-5% Requirements - Proven experience as an MDR security analyst, SOC analyst, or similar role in a fast-paced environment. - Experience providing remote response and remediation activities within networks and on endpoints. - Strong understanding of intrusion detection systems, artificial intelligence-based attack detection and prevention, incident response methodologies, and SOC operations. - Experience with SIEM tools, log analysis, network analysis, endpoint analysis, and threat intelligence platforms. - Solid knowledge of operating systems, networking protocols, and security technologies. - Proficient in incident handling, threat hunting, and forensics. - Excellent analytical and problem-solving skills, with the ability to think critically under pressure. - Strong communication skills to effectively collaborate with cross-functional teams and communicate complex security issues to non-technical stakeholders. - Continuous learning mindset to stay updated with the evolving threat landscape and emerging security technologies. Desirable - Prior experience with Vectra, SentinelOne, Microsoft Defender, or CrowdStrike - Coding experience in Bash, Python, or Powershell - Open-source development Our competitive total rewards package includes cash compensation within the range provided below. Actual pay for this position may vary based on the hired candidate’s location, experience and relevant incumbent pay position. Vectra Total Rewards $90,600—$122,600 USD Vectra provides a comprehensive total rewards package that supports the financial, physical, mental and overall health of our employees and their families. Compensation includes competitive base pay, incentive plan eligibility, and participation in the employee equity plan (stock options). Specific benefits offered varies by location, but commonly include health care insurance, income protection / life insurance, access to retirement savings plans, behavioral & emotional wellness services, generous time away from work, and a comprehensive employee recognition program. Vectra is committed to creating a diverse environment and is proud to be an equal opportunity employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status.
Security Analyst – 3rd Shift
Vectra AIVectra AI is a computer and network security company that utilizes artificial intelligence to automate cyber-attack detection and response in real time within enterprise infrastruc
• Monitor security logs and alerts from various sources, including intrusion detection systems, Endpoint Detection and Response (EDR) systems, and security information and event management (SIEM) tools. • Investigate and analyze security incidents, identify root cause, and develop appropriate mitigation strategies. • Execute security response actions, including full remote remediation of endpoints. • Perform threat hunting and proactive analysis to identify potential security risks and vulnerabilities. • Collaborate with cross-functional teams, including product, engineering, and support, to resolve customer incidents or issues. • Mentor and provide guidance to junior security analysts, sharing knowledge and best practices. • Conduct health checks and architecture reviews, providing technical expertise and real-life experience in creating solutions, designs, and recommendations. • Be a strong voice for your customers across business to identify new detection models, identify new product features, build content for both internal and external customer knowledge bases, and ensure successful Vectra deployments. • Travel expected 0-5%
P36836 IT Access Control Associate (Unfilled)
US Anesthesia Partners, Inc.US Anesthesia Partners, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, gender identity, sexual orientation, pregnancy, status as a parent, national origin, age, disability (physical or mental), family medical history or genetic information, political affiliation, military service, or other non-merit based factors.
Overview US Anesthesia Partners is the highest-quality single-specialty anesthesia practice in the United States, with over 6,000 employees distributed across 10 states. Our clinical and non-clinical staff support each other as they work toward a common vision: Empowering people to advance exceptional care. US Anesthesia Partners is seeking an Access Control Specialist who is responsible for managing user access across enterprise systems, ensuring compliance with internal security policies and external regulatory requirements. This role plays a critical part in safeguarding sensitive data by overseeing provisioning, deprovisioning, and access reviews, while maintaining detailed documentation for audit readiness. The base pay estimate for this role is $37,800 - $60,400 annually. The final offer will depend on the skills, experience, and qualifications of the selected candidate. This range is for base pay only and does not include bonuses or other compensation. This position is eligible for an annual bonus. Bonuses are not guaranteed and are awarded based on company and individual performance. Job Highlights ESSENTIAL DUTIES AND RESPONSIBILITIES: - Processes user access requests, including provisioning, deprovisioning, and modifications, based on control policies and employee status. - Identifies and resolves access issues, ensuring alignment with security policies and regulatory standards. - Monitors and responds to Workday notifications regarding employee terminations, transfers, and role changes; promptly revokes or adjusts access as needed. - Conducts regular access reviews to validate appropriate user access and remove outdated access. - Collaborates with HR, IT, and department leadership to support onboarding, offboarding, and internal transfers. - Maintains detailed documentation to ensure all changes are accurately recorded and auditable. - Participates in internal and external audits by providing access control evidence and responding to inquiries. - Supports automation initiatives related to access provisioning and deprovisioning using tools like Power Automate or ServiceNow workflows. Qualifications KNOWLEDGE/SKILLS/ABILITIES (KSAs): - High school diploma. - 1-3 years of experience with access reviews, audit preparation, and compliance reporting. - Strong understanding of identity lifecycle management and access control best practices. - Ability to manage and protect sensitive information with discretion and accuracy. - Strong organizational and documentation skills including high attention to detail. - Proficient in using Excel, Microsoft Entra ID and access tracking tools. - Excellent verbal and written communication skills. - Proficient in managing and navigating insurance/payer portals for administrative tasks. - Identity & Access Management (IAM): Microsoft Entra ID, Active Directory - Ticketing Systems: ServiceNow, FreshService - Productivity Tools: Microsoft Excel, Power BI, SharePoint, SmartSheet *The physical demands described here are representative of those that may need to be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. - Occasional Standing - Occasional Walking - Frequent Sitting - Frequent hand, finger movement - Use office equipment (in office or remote) - Communicate verbally and in writing
PKI Analyst
ASM ResearchIt is the policy of ASM that an individual's race, color, religion, sex, disability, age, sexual orientation or national origin are not and will not be considered in any personnel or management decisions. We affirm our commitment to these fundamental policies. All recruiting, hiring, training, and promoting for all job classifications is done without regard to race, color, religion, sex, disability, or age. All decisions on employment are made to abide by the principle of equal employment.
Role Description The Customer Support & Billing Operations Specialist plays a key role in supporting daily operational workflows by managing billing related email requests, performing database research, assisting with environment testing, and providing customer support. This position goes beyond traditional call center responsibilities, requiring strong analytical skills, attention to detail, and the ability to work across multiple systems and processes. - Maintains end-to-end responsibility for customer’s support needs providing timely, reliable, and courteous service. - Provides monitoring support and outreach for batch processing issues and errors, edit code rejects, issue follow up and resolution as requested. - Researches and analyzes customer service issues to provide information and solutions in a timely manner. - Works with a moderate degree of supervision to deliver consistent results and effective resolutions to customers. - Provides support to Customer to research and confirm COD processing status of data such as promissory notes, batch status, entrance counseling, exit counseling, borrower, grant recipient, borrower-servicer information, etc. - Performs analysis of COD borrower data integrity situations identified by Customer. - Demonstrates enhanced service skills in identifying core customer issues and providing long-term solutions. - Seeks opportunities to improve workflow and increase efficiencies. Adapts well to new processes and procedures. - Logs cases, or updates an existing case as applicable, to record each phone, email, or web chat communication with a customer. - Support Services shall be executed in compliance with processing and program guidelines published by Customer. - Review, process, and respond to billing related emails and service requests with accuracy and timely follow through. - Conduct research within internal databases and systems to resolve inquiries, validate data, and provide detailed information to customers or internal teams. - Collaborate with technical teams to support testing activities in non-production environments, including validating functionality, documenting findings, and reporting defects. - Handle inbound customer contacts through phone, chat, and ticketing systems, ensuring high quality service and issue resolution. - Maintain accurate records of customer interactions, case notes, and research findings. - Identify process issues or recurring customer problems and escalate appropriately for resolution or improvement. - Assist with special projects, operational tasks, and cross team initiatives as assigned. - Follow documented processes and contribute to updating knowledge articles or workflow documentation. Qualifications - Experience in customer service, billing operations, or technical support preferred. - Strong written communication skills for email handling and documentation. - Ability to research and interpret data across multiple systems. - Familiarity with testing environments or quality assurance tasks is a plus. - Strong attention to detail and multitasking ability. - Proficiency with common office software and ticketing or CRM systems. - Ability to work independently while contributing to a collaborative team culture. Requirements - High School Diploma or GED. - 2-5 years of related experience in Customer Service or public relations. Benefits - Compensation ranges for ASM Research positions vary depending on multiple factors; including but not limited to, location, skill set, level of education, certifications, client requirements, contract-specific affordability, government clearance and investigation level, and years of experience. - The compensation displayed for this role is a general guideline based on these factors and is unique to each role. - Monetary compensation is one component of ASM's overall compensation and benefits package for employees. Company Description It is the policy of ASM that an individual's race, color, religion, sex, disability, age, sexual orientation or national origin are not and will not be considered in any personnel or management decisions. We affirm our commitment to these fundamental policies. - All recruiting, hiring, training, and promoting for all job classifications is done without regard to race, color, religion, sex, disability, or age. - All decisions on employment are made to abide by the principle of equal employment.

