Director of AI-Driven Fraud Investigations

Posted yesterday

coinscaptureClover (SC)

Fraud Examiners, Investigators and Analysts Direct Health and Medical Insurance Carriers

SENIORITY

Manager

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About 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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