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Job SummaryThe 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 - $225,200.00Exact compensation may vary based on skills, experience, and location.
Skills Required
- Bachelor's degree
- 10 years of 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 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 return on investment
- Experience administering government programs
- Experience managing and administering healthcare fraud investigations
- Master's degree
Health Care Service Corporation Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Health Care Service Corporation and has not been reviewed or approved by Health Care Service Corporation.
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Retirement Support — A pension plan alongside a matching 401(k) is offered, an uncommon combination in the private sector. This combination is described as a standout element that helps retain employees.
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Healthcare Strength — Healthcare options are broad, with multiple medical, dental, and vision choices, wellness incentives, and access to resources like on-site fitness centers and an EAP. These offerings add meaningful value beyond base pay.
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Parental & Family Support — Paid parental leave (up to six weeks at full pay after one year), adoption assistance, and mothers’ rooms are available. These supports reinforce family needs alongside work commitments.
Health Care Service Corporation Insights
What We Do
Imagine Something New, Something Different. Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), is the largest customer-owned health insurer in the nation and the fourth largest overall. Operating through our Blue Cross and Blue Shield Plans in Illinois, Montana, New Mexico, Oklahoma and Texas (as well as a variety of affiliates and subsidiaries,) we are expanding access to high-quality, cost-effective health care. We are equipping members with information and tools so they can make the best health care decisions for themselves and their families. HCSC is continuously recognized as an employer committed to community, diversity and inclusion, training and development. HCSC is committed to pioneering the health care space in ways as effective as they are creative. If you are passionate about the impact you want to have through your work, with a desire to apply innovative thinking to new and emerging challenges, we encourage you to learn more about HCSC. Learn about what we stand for, how we work and the difference we’re making in the lives of our 15 million members. Join HCSC and discover what new ways of thinking can mean for you, your community, our customers and our organization. Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.
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