AVP, Special Investigations Unit
Blue Cross NC(1 month ago)
About this role
The AVP, Special Investigations Unit leads the organization’s efforts to detect, investigate, and prevent healthcare fraud, waste, and abuse to safeguard assets and reduce costs. The role defines SIU strategy, capabilities, and analytics tools while positioning the unit to address evolving FWA schemes and integrating with Payment Integrity. The AVP is an external-facing leader who collaborates with regulators, law enforcement, and industry partners to support investigations and reporting.
Required Skills
- Leadership
- Fraud Detection
- Investigations
- Analytics
- Risk Assessment
- Compliance
- Regulatory Relations
- Stakeholder Management
- Reporting
- Team Management
+1 more
Qualifications
- Bachelor's Degree
- Certified Fraud Examiner (CFE)
- Accredited Healthcare Fraud Investigator (AHFI)
About Blue Cross NC
bluecrossnc.comBlue Cross NC makes health insurance easy. Discover employer, individual, family, Medicare & Medicaid plans from Blue Cross NC. Better care starts here.
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