Director, Special Investigations Unit - AHFI

Job Summary The Director, Special Investigations Unit (SIU) reports directly to the VP of Internal Audit Services and leads the SIU strategy and operations to detect, investigate, and recover fraud, waste, and abuse across SCAN’s portfolio. Responsibilities Develop and maintain SIU infrastructure, policies, and procedures. Lead, supervise, and allocate resources for investigative cases. Design and deliver fraud, waste, and abuse (FWA) training to staff across all portfolio companies. Co‑ordinate the overall fraud, waste, and abuse program, ensuring compliance with state and federal regulations. Analyze audit findings, provide executive action plans, and support financial recovery efforts. Monitor and evaluate vendors performing audit and recovery activities. Respond to legal inquiries, subpoenas, and court appearances in collaboration with Legal. Represent SCAN at federal and state fraud meetings, industry events, and professional associations. Build relationships with regulators, investigatory units, and enforcement agencies. Promote a culture of compliance, diversity, equity, inclusion, and belonging throughout the organization. Qualifications Bachelor’s degree or equivalent experience. 10+ years of compliance, FWA, or special investigations experience in managed care or CMS. Experience working with regulatory agencies such as CMS, HHS, and OIG. Prior experience with risk adjustment and coding preferred. Minimum 3 years within the healthcare industry. Certified Criminal Justice Specialist (CCJS) or accredited health‑care fraud investigator (AHFI) preferred. Certified Fraud Examiner (CFE) or Certified Healthcare Compliance (CHC) highly preferred. Benefits Base salary $147,000‑$190,000. Annual employee bonus program. Robust wellness program. Generous paid‑time‑off, 11 paid holidays, 1 floating holiday, birthday off, 2 volunteer days. 401(k) retirement savings plan with employer match. Robust employee recognition program. Tuition reimbursement. Mostly remote work with flexible schedule. Equal Employment Opportunity SCAN is an Equal Employment Opportunity employer and a proud advocate for a diverse, inclusive workforce. Background checks are required. #J-18808-Ljbffr GRP SCAN Group