Investigator, SIU

Clover Health(11 days ago)

RemoteFull TimeMedior$83,000 - $125,000Compliance

About this role

Clover Health is a health insurance company focused on delivering data-driven, preventive care for Medicare members. The Special Investigations Unit (SIU) is a cross-functional team that concentrates on identifying and addressing healthcare fraud, waste, and abuse (FWA) while supporting regulatory compliance. This Investigator role operates within a tech-driven, remote-first environment collaborating across Compliance, Payment Integrity, and Data Infrastructure.

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Required Skills

Fraud Investigation
Audit Strategy
Provider Relations
Regulatory Compliance
Case Management
Policy Analysis
Communication
Data Analysis

Qualifications

CFE
AHFI

About Clover Health

cloverhealth.com

Clover Health is a Medicare Advantage provider offering HMO and PPO plans—many with $0 monthly premiums—bundling expanded benefits like dental, vision, and hearing. Headquartered in Jersey City, NJ, the company serves Medicare beneficiaries across multiple U.S. markets. Clover emphasizes a technology- and data-driven approach to care management, aiming to support providers, coordinate primary care, and improve member outcomes. It positions itself as a member-focused alternative designed to lower costs and simplify access to preventive and routine services.