Job Details

Director Of Investigations

Company name

Organization Type

Public Interest

Job Type

Attorney

Years of Experience

Min 10 yrs required

Location

Irvine, CA

Date Last Verified

Sep 22,2017

Posted on

Aug 24,2017
Practice Area
Litigation >> Litigation - Health Care
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Director of Investigations Duties: Report to the Senior Vice President (SVP)/Chief Risk Officer Provide direction and expertise for the organization's workplace investigations conducted under the whistleblower policy. These investigations involve all areas of improper activity including claims of harassment, discrimination, retaliation and violations of policies and procedures. Investigations that are conducted by or supervised by the Director of Investigations regularly involve highly sensitive, complex, confidential and time sensitive matters. Be the direct supervisor of internal staff investigators and be responsible for management and oversight of outside investigators retained for specific matters. Implement Whistleblower Policies and recommend updates for compliance with State regulations. Act as a liaison to ministries, affiliates and non faith based affiliates for major workplace investigations and information sharing throughout the system. Publicize anti-fraud efforts through digital media, corporate presentations, intranet articles, posters, brochures, and ongoing training to raise the level of fraud, waste, and abuse awareness and the provider community. Be responsible for the development of system-wide training programs to enhance technical skills for all areas of the workplace investigation process. Oversee the system-wide hotline by monitoring and reporting activities to ministry, affiliates and non faith based affiliate's management, the board and senior leadership. Interact regularly with relevant senior management and chief executives on matters concerning investigation findings and outcomes. These interactions frequently involve the presentation of difficult options to senior level leaders regarding matters of significance. Be the primary liaison with the police and outside investigators including regulatory agencies, with the goal of instilling confidence in PSJH's workplace investigation program. Participate with other senior managers to establish strategic plans and objectives.

Qualification and Experience

Qualifications: Bachelor's degree. Law degree -or- advanced degree. State Bar licensure/certification in principle investigator within 1 year of hire. 10 years of experience in fraud and abuse investigations. 10 years of experience in healthcare fraud . Ability to analyze and interpret financial data. Demonstrated ability to plan and organize a system wide program requiring leadership and consensus building skills Knowledge of the workings of the law enforcement community and the ability to establish contacts with the police, FBI, district attorney's office, and other regulatory/investigatory agencies. Demonstrated ability to work as a leader in a collaborative environment, to exercise good judgment, and to bring about consensus on sensitive and politically charged issues among groups possessing diverse options and requirements. Strong investigation background including interviewing skills and the ability to draw out information, interpret responses, and ferret out the truth. . Highly developed technical skills in the conduct of complex and sensitive workplace misconduct investigations. Excellent oral and written communication skills that demonstrate the ability to effectively synthesize, convey and explain information to individuals of all levels of the organization. Ability to draft clear, concise and logical reports, correspondence and summaries. Demonstrated ability to work independently and prioritize projects for completion in a timely manner and ability to work closely with the General Counsel's Office. Knowledge of the rules of evidence, federal and state laws protecting employees against harassment, discrimination, retaliation and employee privacy rights, etc. Ability to serve as a witness and perhaps, as an expert witness, for the organization in administrative hearings, depositions and in court trials. Excellent qualitative and analytical skills as shown by work experience that demonstrates ability to identify, analyze and investigate potential problems; propose and develop action plans; and implement plan to resolve identified issues. Demonstrated understanding of workplace investigations and process. Ability to be an effective trainer both in a classroom setting and on the job. Demonstrated problem solving skills. Preferred: Coursework/training in workplace misconduct investigations. State Bar License in a state. Private Investigator (PI) license state operating in. 5 years of progressively increasing management responsibility leading to high-performing teams and supervising staff investigators.

Additional info

Job Number: 163264

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