Vice President of Investigations

Job Summary

A company is looking for a Vice President, Special Investigations Unit.

Key Responsibilities

• Lead a team focused on detecting, investigating, and mitigating fraud, waste, and abuse in healthcare billing
• Develop and execute FWA investigation strategies in compliance with regulatory obligations
• Oversee the investigation process and maintain partnerships with internal and external stakeholders

Required Qualifications

• Bachelor's Degree in Business Administration, Healthcare Administration, Law, or related field required; Master's Degree or JD preferred
• 10+ years of experience in fraud investigations, healthcare compliance, or regulatory enforcement
• Significant experience managing large-scale FWA programs in a health plan or government agency
• Deep knowledge of federal and state health programs and FWA regulatory frameworks
• Proven leadership experience with cross-functional teams and external regulators