Special Investigation Unit Lead Review Analyst in United States

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Fraud, Waste, and Abuse (FWA) Analyst II identifies and develops potential healthcare fraud leads through data mining, claims analysis, and investigative research. As a key contributor to the SIU lead development process, this role evaluates provider, member, pharmacy, and ancillary healthcare billing patterns for signs of fraud, waste, abuse, and other anomalies. The Analyst II uses internal claims data, analytical tools, business rule results, and industry intelligence to assess potential FWA concerns and determine whether they warrant formal investigation. This role requires strong analytical skills, healthcare claims expertise, and the ability to translate complex data into actionable investigative leads and recommendations. Essential Responsibilities Lead Development & Fraud Detection Develop proactive and reactive leads to identify potential fraud, waste, and abuse. Generate FWA leads by mining claims databases, reporting tools, and investigative systems. Validate and refine leads generated by business rules to assess their credibility and investigative value. Examine spike analyses, utilization trends, payment anomalies, and outlier reports for unusual billing patterns. Evaluate provider, member, pharmacy, DME, transportation, and facility billing for indicators of fraud or abuse. Moni

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Fraud, Waste, and Abuse (FWA) Analyst II identifies and develops potential healthcare fraud leads through data mining, claims analysis, and investigative research. As a key contributor to the SIU lead development process, this role evaluates provider, member, pharmacy, and ancillary healthcare billing patterns for signs of fraud, waste, abuse, and other anomalies. The Analyst II uses internal claims data, analytical tools, business rule results, and industry intelligence to assess potential FWA concerns and determine whether they warrant formal investigation. This role requires strong analytical skills, healthcare claims expertise, and the ability to translate complex data into actionable investigative leads and recommendations. Essential Responsibilities Lead Development & Fraud Detection Develop proactive and reactive leads to identify potential fraud, waste, and abuse. Generate FWA leads by mining claims databases, reporting tools, and investigative systems. Validate and refine leads generated by business rules to assess their credibility and investigative value. Examine spike analyses, utilization trends, payment anomalies, and outlier reports for unusual billing patterns. Evaluate provider, member, pharmacy, DME, transportation, and facility billing for indicators of fraud or abuse. Moni

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Lead, Senior Decision Scientist serves as a strategic analytics and ideation leader supporting Payment Integrity Affordability initiatives with a primary focus on Fraud, Waste & Error (FWE) and Special Investigations Unit (SIU) programs. This role provides leadership and guidance to a team of Decision Scientists while driving the development, evaluation, and implementation of innovative opportunities that improve affordability outcomes and strengthen Payment Integrity capabilities. The Lead Decision Scientist is responsible for establishing analytical frameworks, managing ideation pipelines, defining success metrics, and identifying cross-functional opportunities that create enterprise value across Payment Integrity programs. Required Qualifications 7+ years of experience in healthcare analytics, Payment Integrity, Fraud, Waste & Error (FWE), Special Investigations, or related healthcare operations. 5+ years of experience leading analytical projects or providing technical leadership within a healthcare environment. Demonstrated experience working with healthcare claims platforms including ACAS, QNXT, HRP, or comparable systems. Experience using SAS, SQL, Python, R, or other analytical and statistical programming languages. Experience performing advanced data analysis, opportunity identification, trend analy

Experienced Electrical & Test Engineer Company: The Boeing Company Boeing Defense, Space & Security (BDS) seeks an Experienced Electrical and Test Engineer to serve as an Automated Test Equipment Engineer to join our Patriot Advanced Capability-3 (PAC-3) Electrical Engineering Capability Team in Huntsville, AL . We design, sustain, and upgrade next generation electronics concepts and support production and special test equipment design for increasing capacity requirements. Position Responsibilities: Support design of automated test equipment, development of engineering documentation, and hardware fabrication, integration, and validation testing Develop, document, and maintain electronic and electrical system requirements according to customer desires and contract requirements Create and implement overall Test Equipment Design strategies Review and apply real-time test anomaly troubleshooting and resolution of issues encountered during hardware validation and verification testing Support fielded test equipment hardware and software over the entire product lifecycle Research emerging technologies for potential applications to meet projected requirements Perform Root Cause Corrective Action (RCCA) investigations, troubleshooting, and resolutions This position requires the ability to get a U.S. Security Clearance for which the U.S. Government requires U.S. Citizenship. An interim U.S. secret clearance Pre Start and final U.S. secret clearance Post Start is required. Basic Qualifications (Required Skills/Experience): Bachelor of Science degree in Engineering (with a focus in Electrical, Mechanical or Aeronautical), Computer Sc

About the Team The Industrial Security team enables OpenAI’s classified and national security work by building secure, compliant programs that support government customers and protect sensitive information. We partner across Security, Legal, People, Facilities, Engineering, IT, and program leadership to translate complex government requirements into practical operating models that allow important work to move forward responsibly. Our work spans personnel security, classified facilities, special programs, government customer engagement, and the safeguards required to operate in highly regulated environments. About the Role As a Senior Special Programs Security Manager, you will lead security operations for OpenAI’s Sensitive Compartmented Information (SCI) and Special Access Programs (SAP), serving in customer-designated roles such as Contractor Special Security Officer (CSSO) or Contractor Program Security Officer (CPSO). You will help shape how OpenAI operates across the Intelligence Community and other national security environments, building the relationships, processes, and security foundations required to support classified work at scale. We’re looking for someone who brings deep special programs expertise, sound operational judgment, and the credibility to work directly with government customers and senior internal stakeholders. This is a hands-on leadership role for someone comfortable navigating ambiguity, helping build the function, mentoring future team members, and finding compliant paths forward when mission needs and security requirements intersect. This role is based in San Francisco, CA, or Washington, DC. We use a hybrid work model of three days in the office per week and offer relocation assistance to new employees. Additional onsite presence and occasional travel may be required based on classified program, facility, and government customer needs. This position requires active Top Secret eligibility, current SCI access, and a current counterintelli

About the team Special Situations at OpenAI is the company’s commercial engine for its most complex and consequential opportunities. The team operates where new verticals, partnership models, and customer motions must be invented, before a repeatable GTM or delivery playbook exists, by bringing together product, research, engineering, and GTM leaders around a single outcome. Many of these efforts begin as “new bets” (new verticals, new customer motions, new partnership models) and mature into repeatable ways of working that shape how OpenAI operates at scale. The team acts as a force-multiplier for the company by accelerating decision-making, aligning stakeholders, and converting complex opportunities into durable results. About the role We’re hiring a Deal Lead, Special Situations to help stand up new vertical bets, with a particular focus on partnership development in the semiconductor industry. You will identify where AI can create step-change value for semiconductor companies and ecosystem partners, originate and shape multi-project programs with FDEs and applied researchers, package them into compelling commercial proposals, and execute creative, complex partnerships while keeping executives and cross-functional teams tightly aligned. This role is especially focused on building strategic partnerships in semiconductors. You do not need to be a technical engineer, but you do need to be able to speak the language of the semiconductor industry, build credibility quickly with technical and business stakeholders, and come up the learning curve fast on industry dynamics, workflows, and constraints. A key part of the role is crafting deals with semiconductor companies that demonstrate our unique competitive advantages. To do this effectively, you will need to develop a strong point of view on the market, understand the competitive landscape, and clearly articulate OpenAI’s differentiated value and strategic advantage. Special Situations owns the overall success of each

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The growing DSNP business has created an opportunity for an individual with claims experience, who is familiar with the 837 standard claims format. This individual will own 837 file transmissions to the states, manage and act on state response files, ensuring that all transactions transmitted are complete and error free. Manage and complete error corrections to meet state requirements. Required Qualifications 1&#43; year of experience with encounter data, medical claims, or Medicare/Medicaid. 1&#43; year of experience using FTP and data transfer software. 1&#43; year of data management experience. Preferred Qualifications Experience with Microsoft Access Databases. Analytical skills with the ability to identify and resolve data discrepancies. Working knowledge of the 837 claims files. Education Bachelors degree or equivalent work experience Anticipated Weekly Hours 40 Time Type Full time Pay Range <p s

About the Team OpenAI’s Business organization works with customers and partners on some of our most complex and consequential opportunities. These efforts require rigorous strategy, strong operating leadership, and coordinated execution across commercial, product, technical, deployment, and go-to-market teams. About the Role We are hiring a Business Lead to serve as the operating leader for a strategically important initiative anchored in a major partnership. This person will turn an ambitious, cross-functional mandate into a clear strategy, operating plan, decision structure, and set of measurable outcomes. This role combines strategy and operations, product judgment, commercial skills, and the ability to get things done. You will identify the most promising product and customer opportunities, develop a point of view on how our products should work together, shape the commercial approach, and personally drive execution across both organizations. This is a hands-on role for someone who wants to own outcomes, not just coordinate work. You will structure ambiguous problems, establish priorities, build trusted relationships with internal and external stakeholders, and work across product, engineering, deployment, and go-to-market teams to remove blockers and deliver results. Success means establishing a durable operating model for the initiative, improving decision velocity, translating strategy into coordinated execution, launching a joint go-to-market motion, landing an initial cohort of customers, and delivering a high-quality enterprise deployment. In this role, you will: Own the initiative’s integrated strategy and operating plan, including priorities, desired outcomes, metrics, owners, dependencies, and decision points Structure complex and ambiguous business problems, develop fact-based recommendations, and translate them into clear choices and executable plans Define success measures and build operating reviews that surface progress, risks, tradeoffs, and requi

The Personal Banker SAFE Act is an entry level position responsible for the assistance in the execution of sales, products or service activities in coordination with the customer service team. The overall objective of this role is to foster relations with customers to build loyalty and to help increase sales to individual consumer clients. Responsibilities: Work with business credit requests less than $250K, recognize/refer larger lending opportunities and cross sell treasury and related small business products Build referral business opportunities through Centers of Influence (COIs) and the Member Get Member (MGM) Program Assist in strategies to grow the small business client and implement appropriate sales plans to target Book of Business customers Deliver client services/outbound calls/inbound calls to acquire new relationships and deepen existing relationships through the cross-sell of relevant products and services while delivering remarkable client experience Provide Tellers and other branch staff with coaching and guidance on products and special programs, identifying client needs, and providing appropriate referrals Recognize transaction needs of clients, educate clients on all service and digital channels and leverage technology/ marketing tools available to uncover opportunities, and present product offers/financial solutions Understand and comply with Citibank policies, standards and procedures Appropriately assess risk when business decisions are made, demonstrating particular consideration for the firm's reputation and safeguarding Citigroup, its clients and assets, by driving compliance with applicable laws, rules and regulations, adhering to Policy, applying sound ethical judgment regarding personal behavior, conduct and business practices, and escalating, managing and reporting control issues with transparency. Qualifications:</u

The Personal Banker SAFE Act is an entry level position responsible for the assistance in the execution of sales, products or service activities in coordination with the customer service team. The overall objective of this role is to foster relations with customers to build loyalty and to help increase sales to individual consumer clients. Responsibilities: Work with business credit requests less than $250K, recognize/refer larger lending opportunities and cross sell treasury and related small business products Build referral business opportunities through Centers of Influence (COIs) and the Member Get Member (MGM) Program Assist in strategies to grow the small business client and implement appropriate sales plans to target Book of Business customers Deliver client services/outbound calls/inbound calls to acquire new relationships and deepen existing relationships through the cross-sell of relevant products and services while delivering remarkable client experience Provide Tellers and other branch staff with coaching and guidance on products and special programs, identifying client needs, and providing appropriate referrals Recognize transaction needs of clients, educate clients on all service and digital channels and leverage technology/ marketing tools available to uncover opportunities, and present product offers/financial solutions Understand and comply with Citibank policies, standards and procedures Appropriately assess risk when business decisions are made, demonstrating particular consideration for the firm's reputation and safeguarding Citigroup, its clients and assets, by driving compliance with applicable laws, rules and regulations, adhering to Policy, applying sound ethical judgment regarding personal behavior, conduct and business practices, and escalating, managing and reporting control issues with transparency. Qualifications:</u

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Job Purpose and Summary As an essential member of our Special Needs Plan (SNP) care team, the telephonic Care Manager Specialist (CMS) plays a key role in coordinating the care of our members, particularly those with social determinants of health (SDoH) needs and stable health conditions. The CMS collaborates closely with the Registered Nurse Care Manager, Care Coordinator, Social Worker, and other interdisciplinary care team participants to support the member in maintaining optimal health. This is achieved by evaluating the members’ needs through the completion of the annual Health Risk Assessment Survey, addressing SDoH needs, and closing gaps in preventative and health maintenance care. Key Responsibilities Telephonic Engagement: Dedicate 50-75% of the day to engaging with members and coordinating their care. Member Outreach: Utilize all available resources to connect with and engage “hard-to-reach” members. Care Planning: Partner with members to develop individualized care plans that encompass goals and interventions to meet their identified needs. Documentation: Maintain meticulous documentation of care management activities in the member’s electronic health record. Collaboration: Work with the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining the member’s stable h

You’ve invested a lot of time and energy in your education. Now you want the chance to make your mark. We offer challenging opportunities for you to learn and grow professionally. In our programs, you’ll be immersed in a culture of continuous improvement, with the goal of changing health care for the better. Position Summary: CVS Specialty is a leader in helping people manage their specialty medications that treat complex and chronic conditions. These medications tend to be more complex, can require special storage like refrigeration, or special administration. And most require additional support. That's where we come in. We provide patients information about their health condition, medications and prescription benefit. The pharmacy intern works closely with the pharmacist and technician staff at the CVS Specialty Pharmacy in Fairfield, NJ. In this position, you will gain experience and knowledge on your journey to become a pharmacist. Job functions will include filling prescription orders for dispensing, review and entry of prescriptions, obtaining verbal prescriptions or clarifications from doctor's offices, transferring prescriptions from other pharmacies, counseling patients, and assisting with various clinical projects as needed. All tasks and activities will be performed under the direct supervision of a pharmacist. Required Qualifications: Active Pharmacy Technician License in the state of New Jersey Not on the DEA Excluded Parties List No pending felony charges or convictions for criminal offenses involving controlled substances Education: Current enrollment in a School of Pharmacy OR graduates of international pharmacy school needing to obtain certification of pharmacy practice experience Preferred Qualifications: -One y

Electronic & Electrical System Design Engineer (Associate or Mid-Level) Company: The Boeing Company The Boeing Test and Evaluation (BT&E) organization is seeking an Electronic & Electrical System Design Engineer for the B-1 Bomber Avionics Integrated Support Facility (AISF) at Tinker Air Force Base, OK . The AISF Laboratory Operations Team is responsible for maintaining, configuring, and upgrading avionics hardware and special test equipment used to support development and testing of operational flight software. Other areas of responsibility include engineering and hardware sustainment that extends to multiple air force bases and labs across the United States. The AISF lab team plays a key role supporting the B-1 platform requirements in areas of avionics and weapons integration, by making changes in the lab first to ensure the software and hardware design are ready prior to ground and flight test. This engineering position is part of a small highly collaborative design team working multiple lab changes to satisfy customer requirements and ultimately the airmen who use the weapon system. This position is part of the Laboratory Operations team, comprising engineers, technicians, and cybersecurity professionals. BT&E is currently hiring for a broad range of experience levels including Associate or Mid-Level Electronic & Electrical System Design Engineers. Travel: This position will require occasional domestic travel up to 10% to support program objectives. Position Responsibilities: Design lab changes for new test articles and integration that support platform upgrades Design lab changes to existing systems to reso

The Senior Executive Assistant provides support to another individual or group of individuals by handling correspondence, managing calendars and appointments, arranging conferences and conference calls, making travel arrangements and providing other administrative tasks. Responsibilities: Directly supports a C16 level manager and generally supports an entire department Manages day to day calendar(s) of senior management Coordinates all aspects of executive level manager appointments, meetings, receptions and conference calls May prepare and review materials and correspondence for meetings Assist with creation/modification of presentations, spreadsheets, and other various documents Coordinates travel arrangements; prepare and distribute schedules/agendas for travel Prepares, reconciles, and tracks expense reports through Travel and Entertainment Expense system Orders supplies and process invoices through Procure to Pay system Process and follow-up on Virtual Requests Assists in ad-hoc reports special projects as needed Trains, coaches or guides other administrative staff when required Appropriately assess risk when business decisions are made, demonstrating particular consideration for the firm's reputation and safeguarding Citigroup, its clients and assets, by driving compliance with applicable laws, rules and regulations, adhering to Policy, applying sound ethical judgment regarding personal behavior, conduct and business practices, and escalating, managing and reporting control issues with transparency. Qualifications: Previous office administration experience preferably within a large and complex financial services or similar organization Highly proficient in Microsoft Office Consistently demonstrates clear and concise written and verbal communication skills Demonstra

The Personal Banker SAFE Act is an entry level position responsible for the assistance in the execution of sales, products or service activities in coordination with the customer service team. The overall objective of this role is to foster relations with customers to build loyalty and to help increase sales to individual consumer clients. Responsibilities: Work with business credit requests less than $250K, recognize/refer larger lending opportunities and cross sell treasury and related small business products Build referral business opportunities through Centers of Influence (COIs) and the Member Get Member (MGM) Program Assist in strategies to grow the small business client and implement appropriate sales plans to target Book of Business customers Deliver client services/outbound calls/inbound calls to acquire new relationships and deepen existing relationships through the cross-sell of relevant products and services while delivering remarkable client experience Provide Tellers and other branch staff with coaching and guidance on products and special programs, identifying client needs, and providing appropriate referrals Recognize transaction needs of clients, educate clients on all service and digital channels and leverage technology/ marketing tools available to uncover opportunities, and present product offers/financial solutions Understand and comply with Citibank policies, standards and procedures Appropriately assess risk when business decisions are made, demonstrating particular consideration for the firm's reputation and safeguarding Citigroup, its clients and assets, by driving compliance with applicable laws, rules and regulations, adhering to Policy, applying sound ethical judgment regarding personal behavior, conduct and business practices, and escalating, managing and reporting control issues with transparency. Qualifications:</u