Director, AI-Enabled Fraud Prevention & Investigations

Clover Health is looking for a Director of AI-Enabled Fraud Prevention & Investigations to enhance its fraud detection capabilities within the Legal department. This remote position involves managing investigations into potential provider fraud while also developing AI-driven tools to streamline these processes. The role requires hands-on involvement in creating investigatory methods for Clover’s Medicare Advantage business, collaborating closely with the Special Investigations Unit and legal teams to ensure compliance with policies and regulations. Candidates should possess strong analytical skills and technical expertise, as the position demands building custom scripts and queries to analyze large datasets effectively. The ideal applicant will be innovative and proactive, capable of prototyping detection logic independently. This is a non-attorney role, and while specific qualifications are not mentioned, a background in fraud investigation or data analysis would be beneficial. The position is fully remote, making it suitable for individuals who thrive in a flexible work environment and are eager to leverage AI in fraud prevention efforts.