Director Of Fraud Investigation
By SoFi At Jacksonville, FL, United States
Drive process change management, leveraging data to drive insights and improvement by partnering with Operations analytics.
Partner with workforce management to balance cost and capacity to meet established SLAs.
Identify opportunities to reduce fraud risk while delivering better Member experience.
10+ years of relevant fraud or financial crime operations experience managing multiple teams in a large or super regional Financial Institutions.
Investment Securities Fraud experience is a plus.
Lead and coach investigators on productivity while driving accountability and efficacy.
Special Investigation Unit Investigator
By Centene At , , Fl
Conduct investigations of potential waste, abuse, and fraud
Document activity on each case and refer issues to the appropriate party
Perform data mining and analysis to detect aberrancies and outliers in claims
Develop new queries and reports to detect potential waste, abuse, and fraud
Provide case updates on progress of investigations and coordinate with Health Plans on recommendations and further actions and/or resolutions
Assist with complex allegations of healthcare fraud

Are you looking for an exciting and challenging opportunity to use your analytical skills to help solve complex cases? We are looking for a Case Investigation Analyst to join our team and help us uncover the truth behind our investigations. You will be responsible for analyzing data, conducting interviews, and developing strategies to uncover the facts. If you are a detail-oriented problem solver with a passion for uncovering the truth, this could be the perfect job for you!

Overview Case Investigation Analyst is responsible for conducting investigations into potential cases of fraud, abuse, or other criminal activity. They use a variety of investigative techniques to gather evidence, analyze data, and develop reports to present to law enforcement or other authorities. They must be able to work independently and as part of a team, and must have excellent communication and problem-solving skills. Detailed Job Description Case Investigation Analysts are responsible for conducting investigations into potential cases of fraud, abuse, or other criminal activity. They use a variety of investigative techniques to gather evidence, analyze data, and develop reports to present to law enforcement or other authorities. They must be able to work independently and as part of a team, and must have excellent communication and problem-solving skills. Case Investigation Analysts must be able to identify and analyze patterns of suspicious activity, and develop investigative plans to pursue leads. They must be able to conduct interviews, collect and analyze evidence, and prepare detailed reports of their findings. They must also be able to work with law enforcement and other authorities to ensure that cases are properly investigated and prosecuted. Job Skills Required
• Excellent communication and problem-solving skills
• Ability to identify and analyze patterns of suspicious activity
• Ability to conduct interviews and collect evidence
• Ability to analyze data and develop reports
• Ability to work independently and as part of a team
• Knowledge of relevant laws and regulations
• Knowledge of investigative techniques
Job Qualifications
• Bachelor’s degree in criminal justice, law enforcement, or a related field
• Previous experience in law enforcement or investigations
• Certification in fraud investigation or related field
• Knowledge of relevant laws and regulations
Job Knowledge
• Knowledge of investigative techniques
• Knowledge of relevant laws and regulations
• Knowledge of computer systems and software
• Knowledge of financial systems and processes
Job Experience
• Previous experience in law enforcement or investigations
• Experience in fraud investigation or related field
• Experience in data analysis and report writing
Job Responsibilities
• Identify and analyze patterns of suspicious activity
• Develop investigative plans to pursue leads
• Conduct interviews and collect evidence
• Analyze data and develop reports
• Work with law enforcement and other authorities
• Prepare detailed reports of findings
• Monitor cases and provide updates to authorities