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Organization TypePublic Interest
Years of Experience
Date Last Verified
Director of Investigations The candidate will report to the Senior Vice President (SVP)/Chief Risk Officer. Will provide direction and expertise for the organization's workplace investigations conducted under the whistleblower policy. 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 within firm 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 firm's workplace investigation program. Participate with other senior managers to establish strategic plans and objectives.
Qualification and Experience
The candidate should have a Bachelor's degree. Law degree -or- advanced degree essential. State Bar licensure/certification in principle investigator within 1 year of hire needed. State Bar License desired. Should have 10 years of experience in fraud and abuse investigations. Must have 10 years of experience in healthcare fraud. Must preferably have 5 years of progressively increasing management responsibility leading to high-performing teams and supervising staff investigators. 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 essential. Strong investigation background including interviewing skills and the ability to draw out information, interpret responses, and ferret out the truth needed. Knowledge of the rules of evidence, federal and state laws protecting employees against harassment, discrimination, retaliation and employee privacy rights, etc essential. Coursework/training in workplace misconduct investigations preferred.
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