INSURANCE FRAUD DIRECTOR

State of New Hampshire Job Posting

Insurance Department

Legal Division

21 South Fruit Street, Suite 14, Concord, NH 03301

Insurance Fraud Director

Labor Grade FF

Position #9U525

The salary range for this position is ($82,557.00 - $115,026.00)

*See total compensation information at the bottom of announcement.

The State of New Hampshire, Insurance Department has a full-time vacancy for Insurance Fraud Director.

SUMMARY: Plans, implements, and supervises criminal investigations of providers, resident and non-resident producers, insurance consumers, licensees, other business entities, and/or individuals who are suspected of insurance related criminal activity against property and casualty insurance companies, life and health insurance companies, health plans, health maintenance organizations, insurance agencies and other Department licensees. Works in conjunction with local police departments, the NH Attorney General’s office, the County Attorney offices, and the United States Attorney’s Office in New Hampshire.

MINIMUM QUALIFICATIONS:

Education: Bachelor’s degree from a recognized college or university with major study of Criminal Justice or a related field. Each additional year of approved formal education may be substituted for one year of required work experience.

Experience: Six years of experience in law enforcement performing investigations and/or undercover operations, government regulator performing regulatory investigations, active practice of law, insurance fraud investigator in private practice. Each additional year of approved work experience may be substituted for one year of required formal education.

License/Certification: Valid driver’s license and/or access to transportation for statewide travel.

Preferred Work Traits: Certified Fraud Investigator or Certified Fraud Examiner designation desired. Certification may be acquired within a reasonable period in the position.

Your Experience Counts: Each additional year of approved formal education may be substituted for one year of required work experience and/or each additional year of approved work experience may be substituted for one year of required formal education.

RESPONSIBILITIES:

• Functions as the chief investigator to supervise, direct, and train employees within the Fraud Unit; this training includes how to conduct and manage insurance fraud investigations; how to collect, analyze, and preserve evidence collected; how to conduct witness interviews; how to make investigatory findings from evidence; and how to draft investigatory reports, warrants, and other documents that support criminal proceedings.

• Assigns tasks and evaluates work performed by Fraud investigators and employees. Exercises direct technical supervision over the investigative staff to allocate work assignments according to their individual levels of experience and expertise; regularly reviews work product of Fraud investigators to ensure their work will satisfy legal review and assessment by state prosecutors. Provides supportive and timely feedback to Fraud employees as to how to improve individual performance within Fraud investigations in order to improve the efficiency and effectiveness of the Fraud Unit overall.

• Designs and implements a manual of procedures, including timelines, for Fraud investigations. Prepares a tactical plan for investigations, including review, analysis, and prioritization of investigations within the Fraud Unit. This planning includes managing time and resources of internal Fraud investigators, while providing support to prosecutors and external investigative teams, such as, special investigation units and law enforcement officers, involved in Fraud investigations and criminal proceedings.

• Provides technical expertise to state and federal prosecutors involved in insurance fraud investigations. Prepares monthly insurance fraud investigative reports for the Attorney General’s Office and engages in additional communication with that office as to insurance fraud matters, as needed.

• Works as a liaison between the Department and senior insurance company management, special investigation units, and national/regional criminal investigation units to develop and provide training on fraud prevention programs; engages with these outside entities to support internal fraud investigation and to improve internal investigative procedures relating to fraud investigations.

• Testifies at criminal hearings and trials for state and county prosecutors, the Attorney General’s Office, and the United States Attorney’s Office to present, explain, and defend investigative procedures and findings.

• Monitors all Fraud investigations to evaluate their overall progress, to resolve questions of investigators and/or prosecutors, and to provide additional direction, as needed, to support the investigative team and prosecutors overseeing each criminal case.

• Ensures that investigations are conducted in a fair and professional manner; observes professional and ethical standards to satisfy due process considerations relating to criminal matters; and exercises proper judgment and discretion to maintain confidentiality aspects of investigative information obtained by the Fraud Unit during the course of an investigation.

DISCLAIMER STATEMENT : The supplemental job description lists the essential functions of the position and is not intended to include every job duty and responsibility specific to the position. An employee may be required to perform other related duties not listed on the supplemental job description provided that such duties are characteristic of that classification.

For further information please contact:

Tess Caple

HR Technician

ins-careers@ins.nh.gov

603-271-2261

*TOTAL COMPENSATION INFORMATION

The State of NH total compensation package features an outstanding set of employee benefits, including:

HMO or POS Medical and Prescription Drug Benefits:

The actual value of State-paid health benefits is based on the employee's union status, and employee per pay period health benefit contributions will vary depending on the type of plan selected.

See this link for details on State-paid health benefits:

https://www.das.nh.gov/hr/benefits.aspx

Value of State's share of Employee's Retirement: 13.85% of pay

Other Benefits:

* Dental Plan at minimal cost for employees and their families ($500-$1800 value)

* Flexible Spending healthcare and childcare reimbursement accounts

*State defined benefit retirement plan and Deferred Compensation 457(b) plan

• Work/life balance flexible schedules, paid holidays and generous leave plan

• $50,000 state-paid life insurance plus additional low-cost group life insurance

• Incentive-based Wellness Program (ability to earn up to $500)

Total Compensation Statement Worksheet:

https://www.das.nh.gov/jobsearch/compensation-calculator.aspx

Want the specifics? Explore the Benefits of State Employment on our website:

https://www.das.nh.gov/hr/documents/BenefitBrochure.pdf

https://www.das.nh.gov/hr/index.aspx

EOE

TDD Access: Relay NH 1-800-735-2964