Director - Corp & Financial Investigation

<p><strong>With more than 8,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust. Interested in joining us?</strong></p>

Detroit MI

Blue Cross Blue Shield of Michigan

When you think of <a href="" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />Learn more about your options as an external candidate. <a href="" target="_blank" rel="noopener noreferrer">Click here</a> to view open positions.&nbsp;

keywords: planning,analysis,support,analysis,planning,talent acquisition,management,solutions,compliance,leadership,organization,goals,degree,knowledge,experience,teamwork,maintain,organization,training


Competitive Total Compensation Package

Overview: <p>Responsible for planning, organizing, directing, controlling and leading multiple investigative units and related administrative staff.&nbsp; Set vision and identify strategic direction for the investigative units and related administrative staff.&nbsp; Support corporate goals and objectives and other duties may be assigned.</p>
Responsibilities: <div align="justify"> <p>Direct activities of multiple functional areas, including but not limited to planning, staff development, problem solving and communications. Establish goals and objectives for the investigative units and related administrative staff that support continuous quality improvement. Manage and develop investigative and administrative unit leadership to ensure best practices are being employed to address fraud, waste and abuse as it affects BCBSM&rsquo;s customers and the corporation. Provide effective and efficient solutions to complex business problems.&nbsp; Interact with other corporate units to identify business solutions that help achieve corporate goals and objectives. Provide high level oversight and leadership to business unit and lead change effectively.</p> <p>Directs departmental subordinates as identified on the department organizational chart.&nbsp; Is responsible for direction, coordination, and evaluation of the investigative effort.&nbsp; Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws.&nbsp; Responsibilities include directing the interviewing, hiring, and training of employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.</p> </div>
Requirements: <p><strong>EDUCATION AND/OR EXPERIENCE</strong>&nbsp;</p> <ul> <li>Bachelor's Degree in Criminal Justice, Business Administration or related field required.&nbsp; Master's Degree in related field considered a plus.&nbsp;</li> <li>Five years experience in a managerial role investigating financial fraud, internal affairs, organized crime, white-collar crime or complex investigations working directly with federal, state or local law enforcement agencies.&nbsp;</li> <li>Five to ten years experience supervising the types of investigations listed in #2 above.</li> <li>If a candidate does not possess a Bachelor&rsquo;s Degree two additional years of investigative experience as defined above will supplement each year of formal education that is lacking.</li> <li>To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.&nbsp;</li> <li>Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</li> </ul> <p><strong>OTHER SKILLS AND ABILITIES</strong></p> <ul> <li>Ability to maintain composure and confidence in risk situations and work under minimal direction.</li> <li>Comprehensive knowledge of legal and investigative procedures used in the detection and successful prosecution of health care fraud cases.</li> <li>Completed training in criminal investigative techniques, i.e. interview, interrogation, surveillance, undercover activity and investigative report writing as well as criminal law and procedures.&nbsp;</li> <li>Must possess a detailed understanding of federal and state judicial processes related to fraud prosecutions.</li> <li>Thorough understanding of accounting procedures and data processing systems.</li> <li>Ability to work effectively in a team environment.</li> <li>Other related skills and/or abilities may be required to perform this job.</li> <li>Strong organizational, planning, analytical and communication skills.</li> </ul> <p>&nbsp;</p> <p><strong><em>All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, protected veteran status or status as an individual with a disability.</em></strong></p> <p>&nbsp;</p>