Director of Special Investigations

Job Summary

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

Key Responsibilities

• Establish and operationalize the SIU strategic plan to effectively identify and resolve fraud, waste, and abuse
• Oversee a diverse SIU staff responsible for investigations and resolutions related to healthcare fraud
• Collaborate with internal departments and external agencies to ensure compliance and enhance claims payment integrity

Required Qualifications

• Bachelor's degree in business administration, healthcare administration, finance, accounting, nursing, or criminal justice
• Minimum of 5 years supervisory experience
• 10 years of investigative experience, including 3 years in law enforcement or related fields
• Certified Fraud Examiner and/or Accredited Healthcare Fraud Investigator
• Experience with healthcare data sources and analytics is preferred