Director of Fraud Prevention

A company is looking for a Director, Fraud Detection & Prevention.

Key Responsibilities

Develop and implement a comprehensive fraud, waste, and abuse (FWA) prevention and detection program

Lead investigations into suspected fraud and ensure timely resolution and corrective actions

Monitor industry trends and regulatory changes that may impact FWA exposure

Required Qualifications, Training, and Education

Bachelor's degree required, preferably in a business-related field

7-10 years of experience in healthcare fraud investigations or regulatory compliance

Experience with case management systems, forensic tools, and data analytics platforms

Experience managing cross-functional teams and external audits

Master's degree or professional certifications such as CFE or CIA are preferred