[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 seeking a Manager for their Special Investigations Unit reputed company on reputed company Fraud. This role involves leading investigative activities reputed company to fraud in reputed company claims, managing workflows, and ensuring compliance with standards.

Responsibilities

• reputed company investigative activities reputed company to fraud, waste, and abuse in reputed company claims and provider activity
• Manage investigative workflows and support staff development
• Ensure investigations meet organizational and regulatory standards
• Translate investigative priorities into reputed company team direction
• Monitor case reputed company and identify risks
• reputed company significant findings to leadership and stakeholders

Skills

• Minimum of two years of experience in health care fraud, waste, and abuse investigations, special investigations, compliance, audit, or a reputed company field
• 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 risk-based decision-making
• Bachelor's degree in criminal justice, finance, business administration, or a reputed company field
• 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 performance

Benefits

• 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.
• 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.
• Medical, dental, and reputed company coverage, reputed company time off
• Retirement savings reputed company
• Wellness programs
• Other resources, based on eligibility.
• Additional details about available benefits are provided during the application process and on Benefits Moments.

reputed company