at Health Care Service Corporation in Chicago, Illinois, United States
Job Description
At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.
Come join us and be part of a purpose driven company who is invested in your future!
Job Summary
This position is responsible for identifying, developing, and managing complex, high-impact healthcare fraud investigations resulting in criminal and/or civil prosecution; and may be responsible for establishing and maintaining close liaison, as indicated in Plan design, with internal department personnel, and government officials including law enforcement to further SID investigations and referrals for prosecution of healthcare investigations
JOB REQUIREMENTS:
Bachelor's Degree
7 years law enforcement experience (local, state, or federal) or 7 years fraud investigative experience.
Experience directing complex fraud investigations which result in criminal or civil prosecutions.
Experience planning and conducting interviews which develop significant information in furtherance of complex fraud, waste, and abuse investigations.
Familiarity with state and federal laws applicable to health care fraud.
Ability to develop effective liaison relations which facilitate case identification, investigation, and prosecution.
Ability to independently prepare reports of interview and other documentation accurately reflecting investigative activity and results.
Clear and concise verbal and written communication skills.
Self-motivated, results oriented with demonstrated leadership skills.
PREFERRED REQUIREMENTS:
Experience in Illinois Medicaid Fraud Waste and Abuse investigations
Accredited Health Care Fraud Investigator
Certified Professional Coder
Certified Fraud Examiner
*Please note that this role is HYBRID with an in office requirement of 3 days a week
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Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
HCSC Employment Statement:
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
