Director of Special Investigations

A company is looking for a Director, Special Investigations Unit (SIU).

Key Responsibilities

Drive strategy and results of the Fraud, Waste, and Abuse (FWA) program, monitoring performance and addressing improvement opportunities

Lead the Annual FWA Risk Assessment and develop workplans, ensuring regular updates based on internal and external trends

Manage the SIU in detecting and investigating suspected fraud across various activities and operations

Required Qualifications, Training, and Education

At least 7 years of experience in healthcare compliance, fraud investigations, or law enforcement, with 5 years in a leadership role overseeing an SIU and FWA program

Proven knowledge of CMS, OIG, and DOJ regulatory frameworks governing FWA programs

Strong investigative skills with experience in leading complex investigations

Demonstrated ability to develop long-term strategies that align with organizational goals

Licenses / Certifications Preferred : Certified Fraud Examiner (CFE), Certified Healthcare Compliance (CHC)