Director of Special Investigations

Job Summary

A company is looking for a Director, Special Investigations Unit (SIU).

Key Responsibilities

• Drive strategy and results of the Fraud, Waste, and Abuse (FWA) program, monitoring performance and addressing improvement opportunities
• Lead the Annual FWA Risk Assessment and develop workplans, ensuring regular updates based on internal and external trends
• Manage the SIU in detecting and investigating suspected fraud across various activities and operations

Required Qualifications, Training, and Education

• At least 7 years of experience in healthcare compliance, fraud investigations, or law enforcement, with 5 years in a leadership role overseeing an SIU and FWA program
• Proven knowledge of CMS, OIG, and DOJ regulatory frameworks governing FWA programs
• Strong investigative skills with experience in leading complex investigations
• Demonstrated ability to develop long-term strategies that align with organizational goals
• Licenses/Certifications Preferred: Certified Fraud Examiner (CFE), Certified Healthcare Compliance (CHC)