Supv, FEP Investigations

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years , we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds. About the Role This position manages an SIU Team within the Special Investigations Unit, specifically for our Federal Employee Program. Supervises a team of investigators charged with detecting fraudulent activities by subscribers, providers, groups, and other parties. What You'll Do Provide general supervision to investigators with their case management/prioritization and provide guidance regarding the most efficient and effective method of investigation appropriate for each individual case. Guide investigators in the preparation and documentation of fraud cases for referral to the appropriate agencies and for potential prosecution or civil litigation. Coordinates with SIU Manager or Director regarding approval of settlement terms related to health care fraud investigations. Establishes and maintains liaison with local state and feder