10 siu field investigator jobs found

Responsible   for   planning,   organizing,   directing,   implementation,   and   leading   department   assignments. Position operates within broad objectives to ensure optimum utilization of manpower and budget. Research,   compile   and   analyze   appropriate   and   relevant data   and   make   recommendations   for operational improvements.   Within Clinical Data Strategy & Operations team, the position also provides strategic leadership for clinical data acquisition, exchange, interoperability, adoption, governance, and value realization. ESSENTIAL   DUTIES   AND   RESPONSIBILITIES   include   the   following.   Other   duties   may   be assigned. Leads   in   the   research,   analysis,   identification   and   evaluation   of   data   from   assigned   problems   to evaluate existing and potential trends and issues. Possess and maintain an extensive comprehensive knowledge of BCBSM business, products, programs   (including   provider...

Perform technology functions to include but not limited to business and systems analysis, application development and process improvement. Serve as a liaison between the business area and the IT organization when needed. Identify, document and communicate system and process changes necessary to improve system and operational performance measures.  Possess an in-depth knowledge of line of business while contributing to the identification, analysis and recommendation of technical process improvement initiatives. Design, create and implement technical solutions. Support complex business processes. Conduct data gathering and analysis to understand business strategy requirements. Provide direction for short and long-term planning sessions and provide direction to ensure understanding of business goals and direction. Evaluate ongoing department activity and propose new tools or technologies Assist in the business process redesign and documentation as needed for new technology....

Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Location Details: Hybrid   Position Schedule / Shift: Monday-Friday 8am-5pm ET  Position Summary:    As a Claim Specialist, you will evaluate coverage, assess claim exposures, and make informed decisions that drive fair and timely resolutions. Working closely with members, medical providers, attorneys, and internal partners under minimal supervision, you'll manage challenging and complex claim scenarios while ensuring compliance with applicable regulations and company standards. The ideal candidate will have experience interpreting and applying Michigan No-Fault reform regulations to support accurate claim handling and benefit determinations. This role is ideal for a detail-oriented professional who thrives on problem-solving, sound judgment, and delivering positive outcomes for members.  Key Responsibilities:   Review assigned claims and initiate claim handling activities....

Responsible for planning, organizing, directing, implementation, and leading department assignments.  Position operates within broad objectives to ensure optimum utilization of manpower and budget.  Research, compile and analyze appropriate and relevant data and make recommendations for operational improvements. Leads in the research, analysis, identification and evaluation of data from assigned problems to evaluate existing and potential trends and issues. Possess and maintain an extensive comprehensive knowledge of BCBSM business, products, programs (including provider data, networks, etc.), corporate organizational structure (including functional responsibilities), and basic research principles/methodologies. Manage and monitor multiple projects simultaneously by establishing project plans and objectives to ensure goal attainment within defined parameters. Develop lines of communication to discuss/review results of analysis to management via reports/presentations and...

Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Job Description Location Details: Hybrid Position Schedule / Shift: Monday-Friday 8am-5pm ET  Position Summary:    As a Claim Specialist, you will evaluate coverage, assess claim exposures, and make informed decisions that drive fair and timely resolutions. Working closely with members, medical providers, attorneys, and internal partners under minimal supervision, you'll manage challenging and complex claim scenarios while ensuring compliance with applicable regulations and company standards. The ideal candidate will have experience interpreting and applying Michigan No-Fault reform regulations to support accurate claim handling and benefit determinations. This role is ideal for a detail-oriented professional who thrives on problem-solving, sound judgment, and delivering positive outcomes for members.  Key Responsibilities:   Review assigned claims and initiate claim handling...

Position Summary Responsible for planning, organizing, directing, and executing complex analytical initiatives that support Health Care Value programs and performance management activities. This position operates with a high degree of independence and is responsible for researching, analyzing, and interpreting healthcare data to identify trends, evaluate program performance, quantify savings, and provide actionable business recommendations. The Senior Healthcare Analyst partners with internal stakeholders, vendors, providers, and leadership teams to develop analytical solutions, monitor contractual performance, and deliver strategic insights that improve healthcare affordability, quality, and operational effectiveness. Key Responsibilities Healthcare Analytics & Performance Measurement Lead the research, analysis, and evaluation of healthcare claims, authorization, utilization, provider, and membership data to identify trends, risks, and opportunities....

Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Location Details: Hybrid Position Schedule / Shift: Monday-Friday 8am-5pm ET  Position Summary:    As a Claim Specialist, you will evaluate coverage, assess claim exposures, and make informed decisions that drive fair and timely resolutions. Working closely with members, medical providers, attorneys, and internal partners under minimal supervision, you'll manage challenging and complex claim scenarios while ensuring compliance with applicable regulations and company standards. The ideal candidate will have experience interpreting and applying Michigan No-Fault reform regulations to support accurate claim handling and benefit determinations. This role is ideal for a detail-oriented professional who thrives on problem-solving, sound judgment, and delivering positive outcomes for members.  Key Responsibilities:   Review assigned claims and initiate claim handling...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs. The Opportunity As a dedicated Property Adjuster Specialist , you will work within established guidelines and framework to investigate, evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will confirm and analyzes coverage, recognize liability exposure and negotiate equitable settlements...

Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Location Details: Hybrid Position Schedule / Shift: Monday-Friday 8am-5pm ET  Position Summary:    As a Claim Specialist, you will evaluate coverage, assess claim exposures, and make informed decisions that drive fair and timely resolutions. Working closely with members, medical providers, attorneys, and internal partners under minimal supervision, you'll manage challenging and complex claim scenarios while ensuring compliance with applicable regulations and company standards. The ideal candidate will have experience interpreting and applying Michigan No-Fault reform regulations to support accurate claim handling and benefit determinations. This role is ideal for a detail-oriented professional who thrives on problem-solving, sound judgment, and delivering positive outcomes for members.  Key Responsibilities:   Review assigned claims and initiate claim handling activities....

Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Location Details: Hybrid Position Schedule / Shift: Monday-Friday 8am-5pm ET  Position Summary:    As a Claim Specialist, you will evaluate coverage, assess claim exposures, and make informed decisions that drive fair and timely resolutions. Working closely with members, medical providers, attorneys, and internal partners under minimal supervision, you'll manage challenging and complex claim scenarios while ensuring compliance with applicable regulations and company standards. The ideal candidate will have experience interpreting and applying Michigan No-Fault reform regulations to support accurate claim handling and benefit determinations. This role is ideal for a detail-oriented professional who thrives on problem-solving, sound judgment, and delivering positive outcomes for members.  Key Responsibilities:   Review assigned claims and initiate claim handling activities....