Director of Special Investigations (Healthcare Fraud)

Location: Chicago, Illinois, United States; flex employees are expected to work in the office at least three days per week.

Base pay: $121,200–$225,200 annually, plus eligibility for an annual incentive bonus.

Company

hirify.global is a health insurance organization focused on serving members and customers through healthcare-related operations.

What you will do

• Lead the Special Investigations Department across Texas, Oklahoma, and New Mexico.
• Direct healthcare fraud investigations and oversee the Enterprise-Wide Intelligence Unit responsible for identifying fraud schemes.
• Support 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.
• Oversee SID audit, compliance, budget, and related financial activities.

Requirements

• Bachelor’s degree.
• At least 10 years of experience in law enforcement or conducting complex healthcare fraud or white-collar fraud investigations.
• At least 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.
• Experience conducting cost-benefit analyses to justify investments and ensure ROI.

Nice to have

• Experience administering government programs.
• Experience managing and administering healthcare fraud investigations.
• Master’s degree.

Culture & Benefits

• Curated development plans and professional growth opportunities.
• Health and wellness benefits.
• 401(k) savings plan and pension plan.
• Paid time off, paid parental leave, paid holidays, disability insurance, and supplemental life insurance.
• Employee assistance program and tuition reimbursement.