Senior Investigator

Job Summary

Conducting comprehensive investigations into healthcare provider compliance, the contract-to-hire Senior Investigator will work remotely to analyze documentation, draft detailed reports, and mentor junior investigators while ensuring adherence to regulatory standards.

Key responsibilities

• Conducts and oversees investigations into potential violations of contractual obligations and regulatory requirements
• Drafts and reviews investigative reports and findings documents for internal and client use
• Identifies trends and compliance gaps through in-depth analysis of provider operations and documentation

Required qualifications

• Minimum of four years of post-education work experience in a corporate environment, with at least three years performing investigations directly
• Bachelor's degree in public policy, public health, health administration, business, or a related field from an accredited institution
• Working knowledge of compliance laws and healthcare industry practices
• Familiarity with health insurance cost-sharing requirements for Medicare, Medicaid, and private insurance
• Detail-oriented with strong writing skills