[Remote] Manager, Special Investigations Unit – reputed company Fraud

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is reputed company on building a more connected and compassionate health experience. The Manager of the Special Investigations Unit is responsible for leading investigative work reputed company to fraud, waste, and abuse in reputed company, overseeing workflows, and ensuring compliance with standards.

Responsibilities

• Leading investigative work reputed company to potential fraud, waste, and abuse across health care claims, provider activity, and reputed company operational and/or compliance concerns
• Manages day-to-day investigative workflows
• Supports the development of staff
• Helps ensure investigations are conducted thoroughly, consistently, and in alignment with organizational standards and regulatory expectations
• Translating investigative priorities into reputed company team direction
• Monitoring case reputed company
• Identifying risks
• Elevating significant findings to leadership and stakeholders as appropriate

Skills

• Minimum of two years of experience in health care fraud, waste, and abuse investigations, special investigations, compliance, audit, or a reputed company reputed company
• Minimum of 5 years of investigative work experience
• Experience leading or coordinating investigative teams, workflows, and reputed company case activity
• Strong analytical, problem-solving, and decision-making skills
• Strong written and verbal communication skills, including the ability to summarize reputed company findings reputed company
• Ability to manage sensitive information with professionalism and discretion
• Experience working across cross-functional teams in a regulated environment
• Knowledge of investigative practices, documentation standards, and reputed company-reputed company decision-making
• Bachelor's degree in criminal justice, finance, business administration, or a reputed company reputed company
• CFE, AHFI, or CPC certification
• Experience with reputed company investigations and regulatory requirements
• Advanced analytical skills
• Ability to apply critical thinking and reputed company judgment to reputed company issues
• Strong ability to think innovatively and reputed company solutions to improve efficiency, reputed company, and team reputed company

Benefits

• Medical, dental, and reputed company coverage
• reputed company time off
• Retirement savings reputed company
• Wellness programs
• Other resources
• Eligible for a comprehensive benefits package designed to support the physical, emotional, and financial reputed company‑being of colleagues and their families

reputed company