Senior Compliance Investigator

Office of Compliance Services

Responsibilities

• Lead and conduct complex compliance investigations of reported compliance concerns, involving fraud, waste, abuse, and policy violations.
• Gather, analyze, and evaluate evidence, including documents, data, and records, to support investigative findings.
• Conduct Interviews with employees, patients, and external parties, exercising professionalism and discretion in sensitive situations.
• Prepare clear, detailed investigative reports that outline findings, conclusions, and recommended corrective actions.
• Partner with Legal Affairs, Risk Management, Human Resources, and other stakeholders on investigation outcomes.
• Monitor and evaluate corrective actions to ensure effective resolution.
• Stay current with federal and state healthcare regulations, enforcement trends, and compliance best practices.
• Support the development and delivery of compliance training and education informed by investigation findings.
• Identify trends and emerging risks based on investigation findings and contribute to broader compliance risk assessments, as well as the enhancement of departmental investigative processes and tools.
• Maintain thorough, accurate, and confidential investigation records in compliance tracking systems and databases.

Requirements

• Bachelor’s degree from an accredited academic institution or equivalent experience.
• Minimum of seven years of experience conducting investigations, preferably within a healthcare setting or involving healthcare compliance matters.
• Strong knowledge of federal and state healthcare regulations, including Stark Law, Anti-Kickback Statute, and related laws.
• Demonstrated experience leading investigations, interviewing witnesses, analyzing evidence, preparing investigation reports, and managing corrective action follow-up.
• Experience developing or contributing to educational content or compliance training materials.
• Strong analytical, problem-solving, critical-thinking, organizational, and communication skills.
• Ability to manage multiple investigations, competing priorities, and sensitive matters with sound judgment and professionalism.
• Ability to work effectively with senior management, staff, and cross-functional stakeholders in a complex environment.
• High level of integrity, ethical conduct, and commitment to maintaining confidentiality.
• Proficiency with Microsoft Office applications.
• Experience working with compliance tracking systems or databases and maintaining detailed documentation.

Qualifications

• Advanced degree, such as a JD or Master’s degree, is preferred.
• Prior experience as an investigator with a local, state, or federal law enforcement or regulatory agency, such as HHS OIG or FBI, is highly desirable.

Skills

• Strong analytical, problem-solving, critical-thinking, organizational, and communication skills.

Benefits

• The environment is nurturing and fosters growth.
• Everyone is very welcoming and friendly with supportive management.
• There is a togetherness and higher level of commitment to teamwork.
• There is a diverse and inclusive environment where leadership is invested in your growth and creating real opportunities.
• What you do matters and gives a real sense of purpose.

Pay

Salary Range: $105,700 to $234,500, with an anticipated hiring range between $115,000 to $165,000, depending on qualifications and experience.

Schedule

N/A