Director of Special Investigations

About the role

The Director of Special Investigations will lead the Special Investigations Department (SID) in Texas, Oklahoma, and New Mexico. In addition to directing all healthcare fraud investigations within these states, this position will oversee SID’s Enterprise-Wide Intelligence Unit, which is primarily responsible for identifying healthcare fraud schemes. SID’s primary mission is to seek the criminal prosecution of individuals and entities that defraud HCSC and its customers. This position will serve as the primary liaison with the FBI, the U.S. Department of Health and Human Services (HHS), and other law enforcement agencies. The Director will also partner with other HCSC departments, including Legal, Medical, and Network, on civil and criminal matters related to SID investigations. Additionally, this position will be responsible for audit and compliance activities related to SID operations. The Director will oversee the development and management of the SID budget and related financial activities for Texas, Oklahoma, and New Mexico.

Responsibilities

• Direct all healthcare fraud investigations in Texas, Oklahoma, and New Mexico
• Oversee the Enterprise-Wide Intelligence Unit responsible for identifying healthcare fraud schemes
• Pursue criminal prosecution of individuals and entities that defraud HCSC and its customers
• Serve as primary liaison with the FBI, HHS, and other law enforcement agencies
• Partner with Legal, Medical, and Network departments on civil and criminal matters
• Conduct audit and compliance activities related to SID operations
• Develop and manage the SID budget and related financial activities for Texas, Oklahoma, and New Mexico

Requirements

• Bachelor Degree
• 10 years experience in law enforcement or conducting complex healthcare fraud or white collar fraud investigations
• 4 years of managerial experience
• Administrative and organizational skills
• Clear and concise verbal, written, and interpersonal communication
• Experience developing and maintaining effective liaison relationships
• Ability to translate needs and initiatives into compelling business cases
• Conduct cost-benefit analyses to justify investments and ensure ROI

Preferred Requirements

• Experience in the administration of government programs
• Management and administration of healthcare fraud investigations
• Master’s Degree

Pay

$121,200.00 – $225,200.00. Exact compensation may vary based on skills, experience, and location.