Senior Healthcare Fraud Investigator
Job Summary
To support the DVA VHA in establishing a Fraud Rapid Response Center, the remote Senior Healthcare Fraud Investigator will lead case development by reviewing analytics-generated leads, preparing decision-ready referral packages, and collaborating with federal investigators to combat healthcare fraud, waste, and abuse.
Key responsibilities:
- Review and validate fraud leads generated by analytics, including anomaly detection and network analysis
- Develop comprehensive healthcare fraud cases involving community care providers and suspicious billing patterns
- Prepare detailed referral packages for administrative actions, ensuring accurate documentation and evidence support
Required qualifications:
- Bachelor's degree in a relevant field
- Active Public Trust Clearance
- 8+ years of federal healthcare program integrity and fraud investigations experience
- Working knowledge of healthcare fraud laws, including the False Claims Act and Anti-Kickback Statute
- Experience in developing case documentation and preparing investigative packages
Complete Job Description
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