Job Details

A company is looking for a Director, Special Investigations Unit.Key ResponsibilitiesEstablish and operationalize the SIU strategic plan to effectively identify and resolve fraud, waste, and abuseOversee a diverse SIU staff responsible for investigations and resolutions related to healthcare fraudCollaborate with internal departments and external agencies to ensure compliance and enhance claims payment integrityRequired QualificationsBachelor's degree in business administration, healthcare administration, finance, accounting, nursing, or criminal justiceMinimum of 5 years supervisory experience10 years of investigative experience, including 3 years in law enforcement or related fieldsCertified Fraud Examiner and/or Accredited Healthcare Fraud InvestigatorExperience with healthcare data sources and analytics is preferred