Analista De Compliance : Fraude

Fraud Senior Supervisor

The job profile for this position is Fraud Senior Supervisor, which is a Band 3 Management Career Track Role.

Role Summary

As a Fraud Senior Supervisor within the Member Investigation Unit you will be directly supporting Cigna’s affordability commitment within Cigna International's business and have specific responsibility for the quality and effectiveness of investigations into suspected member behaviours. This role is responsible for managing a team accountable for detecting and recovering FWA payments, creating solutions to prevent claims overpayment and future spend monitoring. This role will partner with internal stakeholders and specifically Client Management Teams to demonstrate good practice anti-fraud services, compliance with global regulatory and legislative requirements and will maintain integrity of all investigative data and reports. He / She will work closely with other PI team members, Medical Economics, Data & Analytics, Claims Operations, Clinical partners and Product.

Responsibilities

• Lead the Member Investigation Team who are responsible for identifying and preventing fraudulent, wasteful and abusive expenses within Cigna’s International Business Market ensuring team targets and KPIs are met.
• Works closely with PI FWA senior management to understand strategy and is responsible for executing departmental plans and priorities.

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