Healthcare Compliance Investigator

Job Summary

Our client is seeking a Compliance Investigator responsible for conducting comprehensive investigations on compliance-related matters submitted through the compliance hotline or other reporting avenues.

Key Responsibilities

• Conduct thorough compliance investigations across business areas, including interviews, data analysis, process reviews, follow-up, and documentation.
• Analyze factual findings to determine appropriate case disposition and ensure timely follow-up.
• Influence decision-making processes, manage difficult conversations, and recommend or enforce corrective actions when necessary.
• Prioritize and manage a large caseload, ensuring timely resolution of all investigative matters.
• Maintain comprehensive case files and provide clear and concise summaries of investigative findings and conclusions.
• Collaborate regularly with colleagues across departments to facilitate investigations and implement corrective actions where needed.
• Provide regular written and verbal updates to leadership on investigation progress and outcomes.
• Partner with other compliance functions and departments to drive overall compliance initiatives across the organization.
• Assist with additional projects and tasks related to the investigative functions as required.

Minimum Qualifications

• Education: Bachelor's degree required; Master's or Law degree or relevant clinical experience preferred, though not required.
• Experience: A minimum of five years of experience leading or conducting internal investigations; healthcare compliance investigations experience preferred.
• Knowledge: Familiarity with federal fraud and abuse laws is preferred.
• Proven Track Record: A history of progressively responsible roles in healthcare organizations, law firms, and/or federal or state health care or enforcement agencies.
• Preferred Experience: Experience working with NAVEX and EthicsPoint compliance systems.

Basic Skills

• Exceptional organizational skills with keen attention to detail.
• Strong time management abilities and the capability to prioritize and meet deadlines in a fast-paced environment.
• Excellent problem-solving and decision-making skills with the ability to identify issues, propose solutions, and implement corrective actions.
• Ability to work independently as well as collaboratively in a team environment, effectively managing projects and delegating tasks when needed.
• Strong interpersonal skills, with the ability to interact effectively at all organizational levels.
• High level of discretion and ability to handle confidential information with sensitivity.

Working Conditions

• Hybrid schedule: Required to be in-office on Tuesdays and Wednesdays during core hours (8:00 AM – 5:00 PM), with additional in-office days as needed for meetings, training, and events.
• Must be able to thrive in a fast-paced environment and manage multiple priorities simultaneously.
• Occasional travel for meetings, audits, and other business-related activities may be required.