Associate Director of Investigations

A company is looking for an Associate Director, Special Investigations Unit to oversee the development and management of SIU programs focused on fraud detection and mitigation. Key Responsibilities Develop and evaluate procedures and training materials related to fraud, waste, and abuse Build relationships with departmental leaders and collaborate cross-functionally Manage SIU inventory and ensure compliance with audit and investigation processes Required Qualifications Bachelor's Degree or equivalent work experience 1+ year experience in health plan compliance 2+ years experience with State DOI health insurance rules and CMS requirements 2+ years experience managing high volume and complicated projects

Mar 25, 2025 - 19:42

A company is looking for an Associate Director, Special Investigations Unit to oversee the development and management of SIU programs focused on fraud detection and mitigation. Key Responsibilities Develop and evaluate procedures and training materials related to fraud, waste, and abuse Build relationships with departmental leaders and collaborate cross-functionally Manage SIU inventory and ensure compliance with audit and investigation processes Required Qualifications Bachelor's Degree or equivalent work experience 1+ year experience in health plan compliance 2+ years experience with State DOI health insurance rules and CMS requirements 2+ years experience managing high volume and complicated projects