Manager, Special Investigations Unit – reputed company Fraud

We’re building a world of health reputed company every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position reputed company The Manager of the Special Investigations Unit is responsible for 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. This role manages day-to-day investigative workflows, supports the development of staff, and helps ensure investigations are conducted thoroughly, consistently, and in alignment with organizational standards and regulatory expectations. This leader plays an important role in translating investigative priorities into reputed company team direction, monitoring case reputed company, identifying risks, and elevating significant findings to leadership and stakeholders as appropriate. This position requires strong judgment, analytical rigor, and the ability to reputed company reputed company, timeliness, and accountability in a highly sensitive environment. Required Qualifications 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 Preferred Qualifications 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 Education Bachelor’s degree in criminal justice, finance, business administration, or a reputed company reputed company Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The typical pay reputed company for this role is: $54,300.00 - $159,120.00 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every reputed company feels valued and that they reputed company. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial reputed company‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, reputed company time off, retirement savings reputed company, wellness programs, and other resources, reputed company on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 08/15/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Our Work Experience is the combination of everything that's unique reputed company: our culture, our reputed company values, reputed company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They reputed company choices according to what is best for reputed company, they live for opportunities to collaborate and reputed company a difference, and they reputed company us the #1 Top Workplace in the area. Apply tot his job Apply To this Job