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Manager Special Investigations at Health Care Service Corporation - ApplyBlast

Manager Special Investigations

Health Care Service Corporation

3 months ago

3.8 on Glassdoor

Chicago, Illinois, United States

Hybrid

Full Time

Senior

0 applicants

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About this role

HCSC is seeking a Fraud Investigations Manager to lead the detection and investigation of healthcare fraud, specifically within IL Medicaid. The role involves managing and training investigators, coordinating with law enforcement, and overseeing anti-fraud activities across various departments. This position requires a hybrid work arrangement with three days in the office and two days remote.

Responsibilities

Manage and train investigators to detect and refer healthcare fraud cases
Establish and maintain liaison with healthcare providers and law enforcement
Coordinate anti-fraud activities with internal departments and legal teams
Ensure evidence integrity for court proceedings and regulatory compliance
Conduct monthly file reviews and direct investigative strategies

Skills

Qualifications

Bachelor's Degree in Criminal Justice, Finance, or AccountingAccredited Healthcare Fraud Investigator (AHFI)Certified Professional Coder (CPC)Certified Fraud Examiner (CFE)Master's Degree (Preferred)

About Health Care Service Corporation

hcsc.com

Headquarters

Chicago, Illinois, United States

Company Size

10001+ employees

Founded

1936

View Profile

Health Care Service Corporation (HCSC) is a mutual legal reserve company and trusted partner in health, offering health insurance plans across Illinois, Montana, New Mexico, Oklahoma, and Texas. With nearly a century of experience, HCSC serves over 27 million people through a portfolio of health benefit solutions designed to deliver access to quality, cost-effective care. The company drives innovations to improve health outcomes and reduce costs for its members, employees, and communities.