Global Fraud & Payment Integrity Lead

The Cigna Group; Glasgow; Hybrid; GBP 65,000 - 95,000; Full time

Benefits offered by this job

Hybrid working model

Flexible working hours

Competitive benefits package

Job summary

The Cigna Group is seeking a Fraud Senior Supervisor to lead the Member Investigation Unit within its international operations. You will oversee investigations into suspected member behaviours, drive anti-fraud outcomes, and collaborate with Client Management Teams to ensure compliance with regulatory requirements and data integrity.

You will manage a team, monitor KPIs, and work with Data & Analytics to develop rulesets for fraud prevention.

Qualifications

• Experience leading operational teams in health insurance or international health care.
• Accredited counter fraud qualification.
• Minimum of 5 years in health insurance or international health care provider experience.

Responsibilities

• Lead the Member Investigation Team to identify and prevent fraudulent, wasteful and abusive expenses within Cigna’s International Business Market.
• Collaborate with PI senior management to execute department plans and priorities.
• Represent Payment Integrity when engaging with external clients and report fraud risks.
• Manage internal stakeholder relationships and provide guidance to Investigators.
• Ensure KPIs are met and PI savings are tracked and reported accurately.
• Utilize data analytics to monitor regional claim patterns and inform PI interventions.

Skills

Team leadership

Fraud management

Analytical skills

Regulatory knowledge

Communication

English fluency

Education

Accredited counter fraud qualification

Tools

Data analytics tools

Job description

The Cigna Group is seeking a Fraud Senior Supervisor to lead the Member Investigation Unit within its international operations. You will oversee investigations into suspected member behaviours, drive anti-fraud outcomes, and collaborate with Client Management Teams to ensure compliance with regulatory requirements and data integrity.

You will manage a team, monitor KPIs, and work with Data & Analytics to develop rulesets for fraud prevention.