Director of Special Investigations
About The Position
The Director of Special Investigations will lead HCSC’s Special Investigations Department (SID) in Texas, Oklahoma, and New Mexico, directing healthcare fraud investigations across those states and overseeing SID’s Enterprise-Wide Intelligence Unit, which identifies healthcare fraud schemes. SID’s primary mission is to seek criminal prosecution of individuals and entities that defraud HCSC and its customers. The Director will serve as SID’s primary liaison with the FBI, the U.S. Department of Health and Human Services, and other law enforcement agencies. The role also partners with HCSC’s Legal, Medical, and Network departments on civil and criminal matters related to SID investigations. The Director is responsible for audit and compliance activities related to SID operations and oversees development and management of the SID budget and related financial activities for Texas, Oklahoma, and New Mexico.
Requirements
- Bachelor’s degree.
- 10 years of experience in law enforcement or conducting complex health care fraud or white collar fraud investigations.
- 4 years of managerial experience.
- Administrative and organizational skills.
- Clear and concise verbal, written, and interpersonal communication skills.
- Experience developing and maintaining effective liaison relationships.
- Ability to translate needs and initiatives into compelling business cases.
- Ability to conduct cost-benefit analyses to justify investments and ensure return on investment.
Nice To Haves
- Experience in the administration of government programs.
- Experience managing and administering health care fraud investigations.
- Master’s degree.
Responsibilities
- Lead the Special Investigations Department in Texas, Oklahoma, and New Mexico.
- Direct healthcare fraud investigations within those states.
- Oversee the Enterprise-Wide Intelligence Unit, which identifies healthcare fraud schemes.
- Pursue criminal prosecution of individuals and entities that defraud HCSC and its customers.
- Serve as the primary liaison with the FBI, the U.S. Department of Health and Human Services, and other law enforcement agencies.
- Partner with Legal, Medical, and Network departments on civil and criminal matters related to SID investigations.
- Oversee audit and compliance activities related to SID operations.
- Develop and manage the SID budget and related financial activities for Texas, Oklahoma, and New Mexico.
Benefits
- Health and wellness benefits
- 401(k) savings plan
- Pension plan
- Paid time off
- Paid parental leave
- Disability insurance
- Supplemental life insurance
- Employee assistance program
- Paid holidays
- Tuition reimbursement
- Other incentives
- Annual incentive bonus plan
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What This Job Offers
Job Type
Full-time
Career Level
Director
