Senior Healthcare Fraud Investigator
Job Summary
Leading healthcare fraud prevention initiatives, the remote Senior Healthcare Fraud Investigator will manage case development and documentation efforts to support oversight of federal healthcare programs serving Veterans.
Key responsibilities
- Review and validate anomalies and provider risk indicators generated through advanced analytics
- Develop case documentation, referral packages, and supporting evidence for healthcare fraud investigations
- Prepare decision-ready case packages with findings, analysis, and recommendations for executive-level reporting
Required qualifications
- 8+ years of experience in federal healthcare fraud investigations or program integrity
- Working knowledge of healthcare fraud regulations, including the False Claims Act and Anti-Kickback Statute
- Strong analytical and investigative skills with executive-level communication capabilities
- Bachelor's degree in a relevant field
- Ability to pass or currently hold a Tier 2 / Moderate Background Investigation (MBI)
Complete Job Description
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