Lead SIU Investigator
Job Summary
Acting as a subject matter expert in Special Investigations Unit (SIU) investigations, the full-time Lead SIU Investigator will provide guidance to staff on compliance and fraud-related matters, manage a caseload of moderate to high complexity, and develop training for junior investigators, all while working remotely across the continental US.
Key responsibilities
- Provides direction and guidance to team members investigating compliance and fraud issues
- Manages investigative caseloads, develops plans, and documents actions thoroughly
- Identifies training needs and mentors junior staff on SIU activities and casework
Required qualifications
- Bachelor's Degree in a related field or equivalent experience
- 5+ years of experience in healthcare fraud-related investigations
- 1+ years of experience in managed care or health insurance
- In-depth knowledge of government programs and healthcare regulations
- Preferred certification as an Accredited Health Care Fraud Investigator (AHFI) or Certified Fraud Examiner (CFE)
Complete Job Description
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