Senior Investigator

Clover Health(11 days ago)

RemoteFull TimeSenior$104,000 - $127,000Special Investigation Unit (SIU)

About this role

The Senior Investigator on Clover’s Special Investigation Unit helps ensure the identification and investigation of healthcare fraud, waste, and abuse (FWA). The role supports building and scaling a compliant FWA audit program at a healthcare-technology startup and contributes to policy and operational improvements.

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Required Skills

Fraud Investigation
Audit Strategy
Regulatory Compliance
Process Improvement
Provider Communication
Case Management
Mentoring
Relationship Building

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.