SIU Major Case Manager (Medical Provider)

Manage operational fraud investigative teams for major cases involving questionable, suspect, or fraudulent activity in the medical provider context. Lead compliance with claims handling laws and unfair claims practices reporting statutes, and help establish fraud control policies and investigative procedures. Evaluate investigation recommendations, authorize proactive investigative actions, and ensure risks are identified and controlled. Provide coaching and performance management while handling complex, high-exposure cases and coordinating with internal partners and counsel.