The Director, Special Investigation Unit provides management oversight of the investigative team from the planning phase through the disposition of cases within the Special Investigations Unit. The Director ensures the team's investigative caseload is effectively and efficiently managed, as well as assigned and closed in a timely manner. This position is dedicated to Community's lines of business (CHIP, Medicaid, Commercial), and oversees all aspects of Fraud, Waste and Abuse within those segments.
Certification (Certified Fraud Examiner, or Accredited Healthcare Fraud Investigator). Master'sDegree (i.e., MBA, J.D., Criminal Justice or Forensic Accounting) preferred.
Seven years of investigative experience (State or local law enforcement, FBI, CIA, DEA, Secret Service, OIG, General Accounting Office, MFCU, government agencies, corporate investigations, insurance company, law firm, accounting firm, auditing or similar professional experience).
Experience working with Medicare and Medicaid regulations.
Understanding of healthcare industry, claims processing, investigative process, and auditing.
Five years in a management position.
Above Average Verbal (Heavy Public Contact)
Writing /Composing (Correspondence/ Reports )
Experience in facilitating and managing projects and teams
Ability to focus on the big picture and thrives in fast paced, multi-project work environment
Strong organizational, interpersonal, and communication skills
Ability to handle multiple tasks and deadlines with attention to detail
Self-starter and problem solver
Internal Number: 148758
About Harris Health System
The Harris Health System is a fully integrated healthcare system that cares for all residents of Harris County, Texas. We are the first accredited healthcare institution in Harris County to be designated by the National Committee for Quality Assurance as a Patient-Centered Medical Home, and are one of the largest systems in the country to achieve the quality standard. Our system includes 23 community health centers, five school-based clinics, a dental center and dialysis center, mobile health units, a rehabilitation and specialty hospital and two full-service hospitals.Ben Taub Hospital is a world renowned Level I Trauma Center with 586 licensed acute-care beds and provides a wide range of specialty care outpatient services. Lyndon B. Johnson Hospital is a 328 licensed bed acute-care hospital with a newly expanded Level III trauma center and a distinguished regional center for neonatal intensive care for high-risk deliveries.Harris Health is a teaching system for Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth). We train the next generation of healthcare providers on the latest medical procedures and technological breakthroughs.With... our fully integrated electronic medical records system, we offer patients the convenience and assurance that their medical history is accurate, safe and available when and where it is needed. Our Medical Home designation ensures that we offer a full range of preventive, specialty and acute care services for the entire family.