Staff Vice President (VP), Special Investigations Unit (SIU)

Staff Vice President (VP), Special Investigations Unit (SIU)

Carelon Payment Integrity is a proud member of the Elevance Health family of companies. Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate, and prevent unnecessary medical-expense spending. Responsible for leading, planning, organizing, and controlling the activities of cross-functional employees engaged in the detection and elimination of fraudulent behavior. Team scope includes 19 direct reports and 600+ total FTEs. Position responsibilities include working with key internal areas and external regulators to address fraudulent activity, preparing internal and external analyses and reports of investigative findings, and establishing processes for handling referrals of suspected fraud and abuse. Requires a BA / BS in business administration, health care administration, criminal justice, nursing, contract administration, or related field and minimum of 10 years investigation, prosecution, or healthcare experience. Preferred skills include current R.N. degree, FBI, HHA-OIG or Department of Justice experience, Law degree or Prosecution experience, and experience in complex, high dollar white collar and / or healthcare investigations. Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution. The salary range for this position is based on a number of legitimate, non-discriminatory factors set by the Company. Elevance Health is a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. Elevance Health operates in a Hybrid Workforce Strategy. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient / member-facing roles to become vaccinated against COVID-19 and Influenza. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender, marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws.