Employment Opportunity

Magellan Health Services, Inc. is hiring an SIU Investigator. A description of the position and the qualifications are detailed below. Training is provided and some travel may be required. Applicants may apply online at www.magellanhealth.com.

SIU Investigator

Description

This position is responsible for conducting objective, fair, thorough, unbiased and timely investigations into allegations of healthcare fraud, waste or abuse committed against company by members, providers or other entities.  The position requires ingenuity and creativity to obtain case information not readily available, along with the ability to work independently with minimum supervision, and good organizational skills needed to manage a high volume of assigned cases as well as the regular exercise of independent judgment and initiative to investigate allegations. The investigator must have the analytical ability necessary to review, interpret and evaluate relevant information essential in resolving sensitive and complex investigations.

Qualifications

A thorough knowledge of the various types of insurance fraud and the strategies and techniques used in their investigation and of federal and state regulations as it relates to those techniques are required. Qualified candidates must have knowledge of various government and professional agencies, bureaus and boards which provide personal identification and licensing information. The position may require knowledge of medical terminology and practices. The candidate must have excellent written and verbal communication skills used for interviewing and corresponding with claimants, attorneys, doctors, law enforcement, etc. The candidate must be able to work independently with minimum supervision and possess good organizational skills. A high degree of integrity and confidentiality is required for handling information that is considered personal and confidential.

James McConville

SIU Investigator

Magellan Health Services

6950 Columbia Gateway Drive

Columbia, MD 21046

Phone: 410–953-4817

Toll Free (800) 458-2740ext. 34817

Fax: (888) 656-1618

E-mail: jvmcconville@magellanhealth.com

www.MagellanHealth.com

“Getting Better All the Time SM

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