NewCompliance Audit / Investigator / Coder - CCS / CPC / or CCA MedStar HealthCompliance Audit / Investigator / Coder - CCS / CPC / or CCAWashington, DC$65,062–$117,291 / yearPerforms concurrent and retrospective coding and documentation or clinical review audits of respective plan service areas including Behavioral Health services and other duties as assigned to detect potential compliance and/or fraud waste and abuse. Conducts provider coding and documentation audits for specific provider types including behavioral health for MFC DC depending upon the health plan that this role supports (MFC MD or MFC DC).
SIU Claims Investigator Lemieux & Associates LLCSIU Claims InvestigatorWashington, DC$25–$32 / hourFull timeNotary license strongly (preferred).Bilingual ability and/or degree in Criminal Justice or related field (preferred).Willingness to travel; flexible schedule (varied/irregular hours).Strong computer and internet skills. Accurately photograph evidence (accident scenes, vehicle damage, etc.).Skills & ExperienceExperience handling complex SIU/Claims cases.
SIU Investigator Allied UniversalSIU InvestigatorSilver Spring, MD$27–$32 / hourAcquire and gather information through use of own discretion, and guidance from clients and case managers, by means of data collection, interviews, research and collaboration with other SIU entities, law enforcement and state Departments of Insurance. High School diploma or higher with a minimum of five (5) years of demonstrated professional law enforcement experience with specific attention to investigations related to fraud.
Investigator Ethos Risk Services LLCInvestigatorWashington, DCREQUIREMENTS: Previous Experience: Demonstrated proficiency in covert surveillance techniques, capturing high-quality video footage, and preparing thorough, well-organized investigative reports. This role involves performing both stationary and mobile surveillance, obtaining video and photographic evidence, and preparing thorough, detailed reports for clients.
NewSUPERVISORY CRIMINAL INVESTIGATOR US Department of StateSUPERVISORY CRIMINAL INVESTIGATORWashington, DC$143,913–$187,093 / yearQualifying specialized experience must demonstrate the following: Conducting investigations (i.e., criminal, civil and administrative) involving government programs, systems and operations, public and private individuals, and corporations or entities; Reviewing and evaluating operational and investigative information to assess quality, accuracy and sound conclusions of work products; Overseeing the development, implementation and adherence to policies and procedures involving programs and investigations; Participating and providing program guidance on investigative initiatives, for both internal and external agency collaboration efforts (e.g.,Task Force, working groups, etc.). Work Life Programs & Benefits - The Office of Inspector General offers many WorkLife programs such Fit Time, Alternative Work Schedules, Telework, Transit Subsidy, Tuition Assistance, Student Loan Repayment programs, Paid Parental Leave, Health Benefits, Life Insurance, Thrift Savings Plan, as well as Vision and Dental benefits.
Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)MD$46,988–$112,200 / yearThis position will routinely handle high profile or highly sensitive matters involving cases that are national in scope, as well as, complex cases involving multi-lines of business, multiple subjects, or intricate healthcare fraud schemes. Strong communication skills, both written and oral, are necessary for the development and implementation of professional presentations for internal and external stakeholders regarding healthcare fraud matters and Enterprise approach to FWA.
Investigator U.S. Department of JusticeInvestigatorWashington, DC$102,415–$133,142 / yearVeterans Preference Documentation, if applicable: In order to verify your Veterans Preference entitlement, you must submit a copy of the Member Copy 4 of your DD-214 (Certificate of Release or Discharge from Active Duty); or if you are a current Active Duty member you must submit a certification on appropriate military branch letterhead that indicates:1) your service dates, 2) expected discharge or release date from active duty with a release/discharge date no later than 120 days from the closing date of this announcement, and 3) the character of service (e.g., Honorable); or other official documentation (e.g., documentation of receipt of a campaign badge or expeditionary medal) that shows your military service was performed under honorable conditions. Best Qualified - applicants possessing experience that substantially exceeds the minimum qualifications of the position including all selective factors, and who are highly proficient in all requirements of the job and can perform effectively in the position; Highly Qualified - applicants possessing experience that meets the minimum qualifications of the position including all selective factors, and who are proficient in some, but not all, of the requirements of the job; Qualified - applicants possessing experience and/or education that meets the minimum qualifications of the position including all selective factors.
EEO and Workplace Investigator HR AnewEEO and Workplace InvestigatorColumbia, MDFounded in 1999, HR Anew is a nationally WBENC certified woman owned small business that provides human resources advisory, workplace investigation, talent, leadership development, and organizational solutions to government, commercial, nonprofit, healthcare, and educational organizations. Our investigation services are supported by a managed service model that includes investigator recruitment and onboarding, training, case assignment, program management, quality review, performance monitoring, reporting, and executive oversight.
Senior Investigator UnitedHealth Group Inc.Senior InvestigatorArlington, VA$60,200–$107,400 / yearWe are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Collaborate with a variety of external sources to identify current and emerging patterns and schemes related to FWA to ensure additional TIP submission.
SIU Senior Analyst, Lead Investigator (Must Reside in Maryland) CVS Health CorpSIU Senior Analyst, Lead Investigator (Must Reside in Maryland)MD$46,988–$112,200 / yearThe lead reviewer is accountable for the validation of existing Fraud, Waste and Abuse business rules/leads designed to detect aberrant billing patterns as reviewing incoming referrals. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Criminal Investigator U.S. Department of Homeland SecurityCriminal InvestigatorWashington, DC$65,562–$121,478 / yearEmployees who transfer to TSA from an agency that allows employees to maintain an annual leave balance higher than the maximum accumulation for the appointed position will have their leave ceiling set to the maximum accumulation for the appointed position (e.g., United States duty location - 240 hours, foreign duty location - 360 hours, or TSES position - 720 hours). Applicants must successfully complete the Criminal Investigator Training Program (CITP) at the Federal Law Enforcement Training Center (FLETC) or other equivalent training (e.g., FBI, DEA, US Postal Inspection Service, Air Force OSI, Army CID, NCIS and DCIS) for the position at the G band level and successfully completed the Criminal Investigator Training Program (CITP) or other equivalent training for the position at the H/I levels.
Special Investigator AmeriHealth CaritasSpecial InvestigatorWashington, DCRemote$80,400–$109,500 / yearWe offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. The Investigator is responsible for conducting comprehensive investigations of reported, alleged or suspected fraud involving the full range of products at the AmeriHealth Caritas Family of Companies (ACFC).
SENIOR OFFICIAL INVESTIGATOR United States Air ForceSENIOR OFFICIAL INVESTIGATORArlington, VA$169,279–$197,200 / yearThe primary purpose of this position is to conduct complaint analyses, inquiries and investigations of Air Force Senior Officials (General Officers, Senior Executive Service Civilians, and Political Appointees) as directed by the Secretary of the Air Force, Chief of Staff of the Air Force, and the Air Force Inspector General. Examples of specialized experience includes mastery knowledge in conducting sensitive and complex administrative inquiries related to fraud, waste, and mismanagement, and a wide variety of matters of interest to regulations by senior officials related to programs and operations throughout the Air Force.
Criminal Investigator (Deputy U.S. Marshal) U.S. Department of JusticeCriminal Investigator (Deputy U.S. Marshal)Washington, DC$54,485–$70,307 / yearThe mission of the USMS includes protection of the judiciary, court security, witness security, asset forfeiture, apprehending fugitives and violent offenders, apprehending and prosecuting unregistered sex offenders, prisoner transportation, management, and custody, and providing assistance in matters of Federal emergencies and other critical incidents. This specialized experience must be gained in a full time certified law enforcement officer position(s) which includes: Independently execute and enforce the civil and/or criminal process; Plan the execution of warrants of arrest; Plan and carry out investigations; Execute warrants of arrest; Lead security assignments for court proceedings in criminal and/or civil trials; or.
Supervisory Criminal Investigator US Department of Health and Human ServicesSupervisory Criminal InvestigatorDC$147,945–$192,331 / yearDuties for the Supervisory Criminal Investigator, GS-1811-15 for the Office of Investigations, includes but not limited to: Serves as liaison with Federal prosecutive and investigative offices for special investigations of highly complex sensitive, multijurisdictional nature with high programmatic and/or national impact, and cases which may involve key executive officials of this and/or other Departments and in state, county, or local governments. Specialized Experience: In addition to meeting the basic requirements above, applicants MUST meet the additional requirements below: Minimum Qualification Requirements For the GS-15 level: Applicants must have 1 year of specialized experience equivalent to the next lower grade level GS-14 in the Federal service which provided the applicant with the knowledge, skills and abilities to perform the duties of the position.
Investigator Sr AmeriHealth CaritasInvestigator SrWashington, DCRemote$92,600–$126,200 / yearWe offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. The Investigator is responsible for conducting comprehensive investigations of reported, alleged or suspected fraud involving the full range of products at the AmeriHealth Caritas Family of Companies (ACFC).
CRIMINAL INVESTIGATOR U.S. Department of Veterans AffairsCRIMINAL INVESTIGATORWashington, DC$63,780–$97,087 / yearSpecial Instructions for Foreign Education: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show that the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university. All candidates who are: Current or former federal employees qualifying as Status Candidates, Federal employees currently serving on a VRA, VEOA eligibles, CTAP/ICTAP eligibles, eligible for special hiring authorities (e.g., the Schedule A appointment for persons with disabilities, or covered by an Interchange Agreement), or VRA eligibles or Land Management employees eligible under Public Law 114-47.
NewSupervisory Criminal Investigator U.S. Department of Homeland SecuritySupervisory Criminal InvestigatorWashington, DC$147,899–$192,275 / yearMilitary Spouses (if applicable) - You MUST submit verification of marriage to the service member (i.e., a marriage license or other legal documentation verifying marriage) &: (1) a copy of your spouses active military orders; OR (2) verification of your spouses 100% service-connected disability (VA Letter &/or DD-214); OR (3) verification of the service members death while on active duty (DD-1300/Death Certificate). "Newly appointed" refers to the first appointment (regardless of tenure) as an employee of the Federal Government, an appointment following a break in service of at least 90 days from a previous appointment as an employee of the Federal Government, or, in certain cases, an appointment following a break in service of less than 90 days from a previous appointment as an employee of the Federal Government.
Criminal Investigator - Special Agent U.S. Department of JusticeCriminal Investigator - Special AgentWashington, DC$106,437–$163,062 / yearStatus Candidates (Merit Promotion and VEOA Eligibles) Career transition (CTAP, ICTAP, RPL) Federal employees - Competitive service Individuals with disabilities Military spouses Peace Corps & AmeriCorps Vista Special authorities Veterans. To be well qualified, you must satisfy all qualification requirements for the vacant position and (for scored examining) score 85 or better on established ranking criteria OR (for category rating criteria) rate equivalent to the Highly Qualified or better category using established category rating criteria.
NewCriminal Investigator U.S. Department of EducationCriminal InvestigatorWashington, DC$125,776–$163,514 / yearAs a Criminal Investigator (Operations Officer), GS-1811-14, you will be responsible for the following: Serves as an advocate for the assigned region, exercising independent initiative and coordination of initial and ongoing criminal, civil and administrative investigations in communicating approaches, benefits and results of pursuing actions with management. Leading and executing the implementation of a non-investigative effort, such as a training event, program, or project, that required a) cross-component or multi-office coordination, b) communication, and c) leadership, or comparable experience that would prepare the candidate to serve and complete training as a certified program/project manager.