Director of Special Investigations Unit

A company is looking for a Director of Special Investigations Unit, Regulatory Operations. Key Responsibilities Acts as a liaison between SIU operations and health plans to ensure smooth workflows and compliance Oversees the development and implementation of antifraud plans and conducts audits Manages vendor case management and ensures timely resolution of disputes and investigations Required Qualifications Bachelor's degree in a related field 8-10 years of relevant experience in special investigations, insurance fraud, or related fields 8-10 years of leadership or supervisory experience Knowledge of payment integrity program protocols and auditing processes Proficiency in Microsoft Access, Word, and Excel

Mar 15, 2025 - 06:22

A company is looking for a Director of Special Investigations Unit, Regulatory Operations. Key Responsibilities Acts as a liaison between SIU operations and health plans to ensure smooth workflows and compliance Oversees the development and implementation of antifraud plans and conducts audits Manages vendor case management and ensures timely resolution of disputes and investigations Required Qualifications Bachelor's degree in a related field 8-10 years of relevant experience in special investigations, insurance fraud, or related fields 8-10 years of leadership or supervisory experience Knowledge of payment integrity program protocols and auditing processes Proficiency in Microsoft Access, Word, and Excel