Job Description
Job Description
CorVel is seeking a dynamic and experienced Special Investigation Director to lead our Special Investigations Unit (SIU). This role is critical in safeguarding the integrity of our claims and managed care operations while ensuring compliance with regulatory standards. The ideal candidate will combine investigative expertise with strategic leadership to enhance CorVel’s market image and deliver measurable results.
This is a remote role.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
- Education & Training: Develop and deliver SIU training programs for CorVel claims and managed care personnel to ensure awareness of fraud indicators and compliance requirements.
- Data Mining & Analysis: Utilize ISO and other data sources to identify red flags and determine when further investigation is warranted.
- Vendor Audits: Review and analyze audit findings from strategic vendors to ensure adherence to contractual and regulatory obligations.
- Regulatory & Carrier Coordination: Serve as the primary liaison with regulatory bodies and carrier partners, ensuring timely communication and compliance.
- Market Image Enhancement: Promote CorVel’s reputation for excellence in SIU investigations through proactive engagement and thought leadership.
KNOWLEDGE AND SKILLS:
- Strong knowledge of ISO data systems, regulatory requirements, and investigative best practices.
- Exceptional communication, analytical, and leadership skills.
QUALIFICATIONS:
- Bachelor’s degree in Criminal Justice, Business Administration, or related field (Master’s preferred).
- Minimum 7–10 years of experience in insurance fraud investigations, SIU leadership, or related roles.
- Ability to travel as needed.
PAY RANGE:
CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range, and these adjustments would be clarified during the offer process.
Pay Range: $97,019 - $163,027
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.
ABOUT CORVEL:
CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
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