Director of AI-Driven Fraud Investigations
coinscaptureClover, SC
Director of AI-Driven Fraud Investigations
coinscaptureClover, SC
yesterday
Occupations
Fraud Examiners, Investigators and AnalystsCompliance ManagersMedical and Health Services ManagersIndustries
Direct Health and Medical Insurance CarriersAll Other Insurance Related ActivitiesPharmacy Benefit Management and Other Third Party Administration of Insurance and Pension FundsAbout the role
Clover Health is seeking a Director, AI-Enabled Fraud Prevention & Investigations to join its Legal & Compliance team. This hybrid role leads hands-on investigations and builds AI-powered tooling to detect and prevent provider fraud in Medicare Advantage.
You will work with the SIU and other stakeholders to ensure compliant, defensible outcomes. You will prototype investigative workflows, manage a portfolio of cases, and communicate findings clearly to senior leadership.
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JOB OVERVIEW
Experience level
Manager
Location
Clover, SC
Occupation
Fraud Examiners, Investigators and Analysts
Industry
Direct Health and Medical Insurance Carriers
Posted
yesterday
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