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Clover Health
Director, AI-Enabled Fraud Prevention & Investigations
Remote · Full time · Senior level
$150k–$240k / year
About the role
Lead AI-powered fraud investigations and develop investigatory tools for Clover's Medicare Advantage business. Collaborate with legal and SIU teams to ensure compliance and improve fraud detection.
What you’ll do
• Build AI investigative tooling and scripts. • Manage end-to-end fraud investigations. • Develop defensible case documentation. • Collaborate with cross-functional teams. • Communicate findings to leadership.
What you’ll bring
• Experience in healthcare fraud investigations. • Proficient with AI and LLMs for data interrogation. • Strong written and verbal communication. • Knowledge of Medicare Advantage fraud schemes. • Ability to build investigative tools.
Life at Clover Health
Offers competitive salary, equity, bonuses, 401k matching, comprehensive health coverage, mental health resources, remote-first culture, and professional development.
About Clover Health
Clover Health reinvents health insurance using data and empathy to improve member health and healthcare outcomes.