Special Investigations Unit Director jobs in Minnesota

Special Investigations Unit Director oversees the operations for conducting thorough investigations. Develops the strategies for the cross-functional detection and elimination of fraudulent behavior. Being a Special Investigations Unit Director prepares investigative reports and analyses that pertinent to evidence obtained during investigations. May coordinate with outside sources such as law enforcement agencies, and external audit, etc. Requires a bachelor's degree. Additionally, Special Investigations Unit Director typically reports to top management. The Special Investigations Unit Director manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a Special Investigations Unit Director typically requires 5 years experience in the related area as an individual contributor. 1 - 3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)

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Special Investigation Unit Investigator
  • Hennepin County
  • Minneapolis, MN FULL_TIME
  • Hennepin Health (HH) is seeking a Senior Investigator to lead Special Investigation Unit (SIU) functions. The Senior Investigator will be responsible for managing a comprehensive program to combat suspected fraud, waste or abuse (FWA) and leading FWA investigations from triage to conclusion.

    Current Hennepin County employees who refer a candidate hired into an open competitive position may be eligible for a $500 referral bonus. For more information visit employee referral program.

    Location and hours: 
    This position is hybrid and will be performed both on-site at the Hennepin County Health Services Building, 525 Portland Avenue, Minneapolis, MN 55415, and remote as job duties require. Work hours will be Monday through Friday, with typical hours of 8 a.m. to 4:30 p.m. While this position is designated as hybrid, based on current requirements hires must reside in or relocate to Minnesota or Wisconsin.  

    New employees who are hired into remote or hybrid positions between January 2, 2022 to December 31, 2024, will receive $500 toward the cost of establishing consistent internet connectivity, payable upon completion of 6 months of employment. 

    About the position type:
    This is a full-time, benefit-earning position.
    This position is internally classified as an Administrative Assistant, Senior.
    Click here to view the job classification specification. 

    In this position, you will:
    • Research and identify potential areas of fraud, waste, and abuse (FWA).
    • Identify and request data to facilitate investigations, including the creation and utilization or analytic reports.
    • Manage investigations from identification and triage until completion.
    • Make recommendations on final disposition of cases.
    • Work with other departments of Hennepin Health to effectuate case dispositions (e.g. implement payment suspensions, make policy updates, provider outreach, etc.).
    • Work with the investigation areas of our vendors.
    • Work with our partners in the county, state, and federal government.
    • Create regular reports for Hennepin Health’s Board and regulators.
    • Act as the subject matter expert on areas related to FWA.
    • Manage existing policy and procedure documents related to FWA investigations.
    Need to have:
    • One of the following:
      • Eight or more years of experience in *general administrative work relating to the management of departmental/organizational operations or in a specialty area appropriate to the position.
      • Bachelor's degree or higher in public administration, business administration, public health, criminal justice, health care administration or other field appropriate to the position and four or more years of experience in *general administrative work relating to the management of departmental/organizational operations or in a specialty area appropriate to the position.
    *General administrative work is defined as the administration and/or management of programs, policies, and/or budgets. 

    Nice to have:
    • Certified Fraud Examiner (CFE) credential or Accredited Health Care Fraud Investigator (AHFI) designation.
    • Experience with:
      • Medicaid, MinnesotaCare, Medicare, or other publicly funded health programs.
      • Healthcare fraud investigations.
      • Claims or claims processing with knowledge of medical terminology, costs, and enrollment.
      • Working with or for a managed care organization.
    • Knowledge of:
      • State and federal laws and regulations pertaining to health insurance and/or government programs, including Medicare and/or Medicaid.
      • Microsoft Office Suite (Excel, Word, OneNote, Teams, Outlook), Google Sheets, and industry claims platforms (e.g. Facets).
    • Ability to:
      • Request, use, and analyze data to perform investigations. 
      • Have excellent verbal and written communication skills.


    About the department:
    Hennepin Health provides health care coverage to Hennepin County residents who are enrolled in a Minnesota Health Care Program. Hennepin Health is a nonprofit, state-certified health maintenance organization that contracts with the Minnesota Department of Human Services. We envision being a leader in partnering with our members and communities to improve health, by integrating health care and service to enhance the health and well-being of our members and the community.    

    About Hennepin County:
    Hennepin is the largest county government organization in Minnesota. Our employees work every day to improve the health, safety and quality of life for our residents and communities. All of our jobs align to one or more of our overarching goals -- that Hennepin County residents are healthy, protected and safe, self-reliant, assured due process, and mobile.
     
    Our employees receive a combination of generous benefits and positive workplace culture not found at other organizations. This includes meaningful work that impacts our community, competitive pay, work-life balance, a variety of benefits and opportunities to grow. Learn more at The Bridge (log in as Guest).

    Hennepin County envisions an organization where our commitment to diversity and the reduction of disparities is fundamental in providing excellent service to our community.
     
    Your future. Made here.
     
    This posting may be used to fill current and future vacancies.

    This position will have access to systems or other documentation that contains HIPAA data. 

    Invitations to interview will be based upon an assessment of education and experience. Final candidates may be required to complete a background check.

    If you have any questions, please contact:
    Taylor Dahlberg
    Taylor.Dahlberg@hennepin.us  
  • 17 Days Ago

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Unit Director
  • Camp Fire Inland Southern California
  • Excelsior, MN FULL_TIME
  • ERROR The requested URL could not be retrieved The following error was encountered while trying to retrieve the URL: http://prod.goggles.really.mesh:8084/api/v1/proxy? Unable to forward this request a...
  • 2 Days Ago

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Director of Special Education
  • Hiawatha Valley Education District
  • Winona, MN FULL_TIME
  • JobID: 505 Position Type: Administration/Director of Special Education Date Posted: 4/27/2023 Location: SPECTRUM Date Available: 23-24 SY Hiawatha Valley Education District is looking for a Director o...
  • 6 Days Ago

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Executive Director of Special Services
  • Northeast Metro 916 Intermediate School District
  • White, MN FULL_TIME
  • Position Type: Administration/Executive Director of Special ServicesDate Posted: 3/8/2024Location: District Office (White Bear Lake) Additional Information: NORTHEAST METRO 916 INTERMEDIATE SCHOOL DIS...
  • 15 Days Ago

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Director of Special Services
  • Elk River Area School District
  • River, MN FULL_TIME
  • JobID: 16111 Position Type: Administration/Director Special Services Date Posted: 1/25/2024 Location: District Office Date Available: 07/01/2024 Closing Date: 02/19/2024 DESCRIPTION: Under the directi...
  • Just Posted

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SIU/WC Investigator
  • Command Investigations
  • Minneapolis, MN PART_TIME
  • Seeking experienced Claims/SIU and/or Workers’ Comp. Investigators for Insurance Investigations that include Recorded Statements, Accident Scene, and Industrial/workplace accidents. We are seeking ind...
  • 25 Days Ago

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National Account Manager
  • Lincoln Search Consultants
  • Columbus, OH
  • This privately held financially stable client is seeking a Business Development Manager to be the main point of contact ...
  • 3/28/2024 12:00:00 AM

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National Account Manager
  • Management Business Solutions
  • Columbus, OH
  • This privately held financially stable client is seeking a Business Development Manager to be the main point of contact ...
  • 3/28/2024 12:00:00 AM

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Director, Background Investigations
  • Fidelity Investments
  • Roanoke, TX
  • Job Description: The Role Fidelity's reputation is built on trust. The mission of Fidelity Background Investigations is ...
  • 3/28/2024 12:00:00 AM

C
Part-Time Firefighter
  • City of Oberlin, OH
  • Oberlin, OH
  • Salary: $15.00 Hourly Location : Oberlin, OH Job Type: Part-Time Job Number: 202100061 Department: Fire Opening Date: 07...
  • 3/28/2024 12:00:00 AM

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Human Resources Officer
  • City of Bangor, ME
  • Bangor, ME
  • Get Email Updates Subscribe to Receive Email Notifications from the City of Bangor City Directory View a list of City Co...
  • 3/28/2024 12:00:00 AM

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Marketing/Digital Communications Coordinator
  • Marianist Province of the United States
  • St Louis, MO
  • THE MARIANIST PROVINCE OF THE UNITED STATES POSITION DESCRIPTION TITLE: Marketing/Digital Communications Coordinator FLS...
  • 3/27/2024 12:00:00 AM

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Senior Clinical Research Coordinator
  • Brigham and Women's Hospital
  • Boston, MA
  • The Men's Health: Aging and Metabolism Clinical Research Unit at Brigham and Women's Hospital conducts government and in...
  • 3/26/2024 12:00:00 AM

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Claims Coordinator
  • Plastic Express
  • Baytown, TX
  • Company Overview Come join a winning Team! Since 1970 Plastic Express has met the bulk trucking, bulk terminal, packagin...
  • 3/26/2024 12:00:00 AM

Minnesota (/ˌmɪnɪˈsoʊtə/ (listen)) is a state in the Upper Midwest and northern regions of the United States. Minnesota was admitted as the 32nd U.S. state on May 11, 1858, created from the eastern half of the Minnesota Territory. The state has a large number of lakes, and is known by the slogan the "Land of 10,000 Lakes". Its official motto is L'Étoile du Nord (French: Star of the North). Minnesota is the 12th largest in area and the 22nd most populous of the U.S. states; nearly 60% of its residents live in the Minneapolis–Saint Paul metropolitan area (known as the "Twin Cities"). This area i...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Special Investigations Unit Director jobs
$158,980 to $239,471

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