Hcsc

Hcsc

Manager Special Investigations

Chicago Illinois HQ (300 E

Sponsorship not specified$93k-$168kDetected 12 days ago
Data AnalysisComplianceAccountingExcelHIPAALeadershipCommunicationOrganizational SkillsMicrosoft OfficeClaims Management

About the role

  • HCSC is looking for a dynamic individual to join its Fraud Investigations team!
  • This position will be responsible for managing healthcare fraud and internal fraud investigations initially focusing on IL Medicaid
  • establishing and maintaining liaison with healthcare providers and law enforcement

Responsibilities

  • managing and training investigators as well as support staff
  • Develop and maintain liaison contacts with law enforcement.

Requirements

  • 1 year of leadership or supervisory experience.
  • Keen analytical, interviewing, and investigative skills, with proficiency in data analysis and claims management systems.
  • Proficiency in anti-fraud analytics tools, case management software, and MS Office (Word, Excel, PowerPoint) as well as Workday.
  • Master's Degree.
  • Experience with IL Medicaid FWA investigations.

Skills

  • Strong organizational skills and results oriented with demonstrated leadership capabilities.

Compensation

  • The compensation offered will vary depending on your job-related skills, education, knowledge, and experience.
  • This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.
  • $92,700.00 - $167,500.00
  • Exact compensation may vary based on skills, experience, and location.
  • Base Pay Range

Benefits

  • At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work.
  • Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.
  • The compensation offered will vary depending on your job-related skills, education, knowledge, and experience.
  • This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.
  • Develop and manage investigative group designed to detect, investigate, and refer health care fraud cases to law enforcement.
  • Develop and maintain sources of information needed to detect health care fraud.
  • Ensure investigators are familiar and utilize health care fraud databases, including Fraud and Abuse Management System (FAMS).

Company info

  • Deal directly with HCSC customers on fraud matters when appropriate.
  • Communicate and interact effectively and professionally with co-workers, management, customers, etc.
  • Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Equal opportunity

  • We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued.

Visa & Work Authorization

  • NOTE: relocation is NOT offered, sponsorship will NOT be extended either now or in the future.

This listing is sourced directly from Hcsc's careers page and normalized into a canonical job model.