Director of Special Investigations

About this role

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

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.

JOB REQUIREMENTS: • Bachelor Degree. • 10 years 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. • Experience developing and maintaining effective liaison relationships. • Translating needs and initiatives into compelling business cases. • Conducting cost-benefit analyses to justify investments and ensure ROI.

PFREFERRED JOB REQUIREMENTS: • Experience in the administration of government programs. • Management and administration of health care fraud investigations. • Master’s Degree

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement: 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. From 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, plus other incentives, we offer a robust total rewards package for employees.  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.

HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range $121,200.00 - $225,200.00 Exact compensation may vary based on skills, experience, and location.

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