Healthcare Fraud Investigator CONTACT GOVERNMENT SERVICESHealthcare Fraud InvestigatorWashington, DC$85,000–$105,000 / yearCommunication skills: Ability to interact professionally and effectively with all levels of staff including AUSAs, support staff, client agencies, debtors, debtor attorneys and their staff, court personnel, business executives, witnesses, and the public. The candidate must take the initiative to ask questions to successfully complete tasks, perform detailed work consistently, accurately, and under pressure, and be enthusiastic about learning and applying knowledge to provide excellent litigation support to the client.
Healthcare Fraud Investigator Contact Government Services LLCHealthcare Fraud InvestigatorWashington, DC$85,000–$105,000 / yearCommunication skills, Ability to interact professionally and effectively with all levels of staff, including AUSAs, support staff, client agencies, debtors, debtor attorneys, and their staff, court personnel, business executives, witnesses, and the public. The candidate must take the initiative to ask questions to successfully complete tasks, perform detailed work consistently accurately and under pressure, and be enthusiastic about learning and applying knowledge to provide excellent litigation support to the client.
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.
Fraud Investigator-Kansas City, MO area Blue Cross and Blue Shield of Kansas CityFraud Investigator-Kansas City, MO areaBaltimore, Missouri3 years' experience conducting healthcare FWA investigations at a health insurer; experience analyzing claims data to identify FWA trends and patterns using tools such as Excel and business intelligence platforms (e.g., Power BI, Business Objects). Knowledge of major BCBSKC business systems (e.g., Facets, ITS Host and Home) and operational processes (e.g., Claims Processing, Pharmacy, Provider Contracting/Relations, Member Services, Customer Service).
Criminal Investigator - Desk Officer - 90413566 - Washington (Washington, DC, US, 20002) AmtrakCriminal Investigator - Desk Officer - 90413566 - Washington (Washington, DC, US, 20002)Washington, DC$136,721–$184,573 / yearServes as the primary contact and liaison between the Office of Investigations field offices and headquarters, providing technical advice; coordinating and reviewing field office operations and investigative work; and advising leadership on significant investigative developments, field office performance, operational and policy issues, and matters requiring leadership review. The position supports investigative quality and consistency by monitoring complex and sensitive casework, assessing trends and deficiencies, coordinating headquarters actions, reviewing reports and case management data, and recommending improvements to policies, procedures, internal controls, and investigative practices.
Investigator (Hotline) U.S. Department of DefenseInvestigator (Hotline)Alexandria, VA$121,785–$158,322 / yearMilitary Spouse Preference (MSP) Eligible: If you are a Military Spouse Preference applicant, you must include a completed copy of the Military Spouse PPP Self-Certification Checklist dated within 30 days along with the documents identified on the checklist to verify your eligibility for Military Spouse Preference. Alternatively, If you are a current military member in active duty service and do not have a copy of your DD Form-214, you must submit a written documentation (certification) from your branch of service certifying that you are expected to be discharged or released from active duty under honorable conditions no later than 120 days after the date the certification is submitted with your application for this position.
NewInvestigator U.S. Department of Homeland SecurityInvestigatorWashington, DC$121,785–$158,322 / yearThis job is open to Internal Employees - current FEMA employees on a career/career conditional appointment in a competitive service position; current FEMA employees who have previously held a career/career conditional appointment in the competitive service; current FEMA employees who are DRRA Eligible; and FEMA Career Transition Assistance Program (CTAP Eligibles) only. You may need to upload multiple SF-50s, one that shows your competitive eligibility and another for time in grade: Competitive Eligibility: Submit an SF-50 that demonstrates your current or previous appointment to a permanent or conditional competitive service position, including your current or highest grade level, career or career conditional tenure and status in the competitive service, or proof of permanent appointment if applying based on an interchange agreement.
Employee Relations Investigator Lead Booz Allen Hamilton IncEmployee Relations Investigator LeadMcLean, VA$86,800–$198,000 / yearOnsite: If this position is listed as onsite, work will primarily be performed at a Booz Allen office or customer facility, where employees will collaborate directly with colleagues and customers as required by the role. This individual must exercise exceptional independent judgement, operate with high discretion, and possess the ability to spot issues promptly, identify legal risks, and offer practical, risk-balanced solutions.
NewSenior Compliance Investigator Centene Corporation GroupSenior Compliance InvestigatorMD$70,100–$126,200 / yearLeads and conducts compliance and ethics investigations across all business units and health plans, including but not limited to assessment of allegations, review of relevant documents, witness interviews, analysis of facts, root cause analysis, and preparation of investigation reports with recommended remedial or disciplinary actions. Education/Experience: A Bachelor's Degree in Related Field or Associates with 5 years of applicable experience, or a High School/GED with 6 years of applicable experience may substitute for the Bachelor's Degree, required.
NewEmployee Relations Investigator Booz Allen Hamilton Inc.Employee Relations InvestigatorMclean, VA$77,600–$176,000 / yearOnsite: If this position is listed as onsite, work will primarily be performed at a Booz Allen office or customer facility, where employees will collaborate directly with colleagues and customers as required by the role. Salary at Booz Allen is determined by various factors, including but not limited to location, the individual's particular combination of education, knowledge, skills, competencies, and experience, as well as contract-specific affordability and organizational requirements.
Smoking Enforcement Investigator Macpower Digital Assets Edge Private LimitedSmoking Enforcement InvestigatorWashington, DC$90,000–$110,000 / yearKey Responsibilities: Conduct routine and complaint-driven inspections of workplaces, public places, and establishments for compliance with smoke-free and tobacco-control laws. Issue notices of infractions for smoking, signage, or tobacco control violations.
Supervisory Wage and Hour Investigator (ADD) U.S. Department of LaborSupervisory Wage and Hour Investigator (ADD)Washington, DC$106,955–$139,043 / yearYou must meet the following Individual Occupational Requirements (IOR) and the Specialized Experience to qualify for Supervisory Wage and Hour Investigator (Assistant District Director): Applicants must meet at least two of the following three specialized criteria requirements: General knowledge of Federal wage and hour labor laws, industrial occupations, wage scales, employment practices, or salary and wage administration practices. Our mission is to protect rights related to minimum wage, overtime, child labor, family and medical leave, employment conditions for migrant workers, lie detector tests, garnishments, prevailing wages on government-funded contracts, labor provisions of several guest worker programs, and more.
Clinical Investigator Behavioral Health Centene Corporation GroupClinical Investigator Behavioral HealthMD$56,200–$101,000 / yearPosition requires the associate to verify authorization for services and written documentation of services provided against claim information, ensure the appropriateness and accuracy of diagnosis and procedure codes supporting such claims, coordinate medical necessity and appropriate level of care determinations with Medical Directors, and validate services against CMS and State-specific coverage, limitations and exclusion guidelines. 3+ years of providing direct Psychotherapy or Inpatient group therapy within inpatient psychiatric hospitals or units, residential treatment centers, substance abuse rehabilitation facilities, military or veteran hospitals.
Supervisory Wage and Hour Investigator U.S. Department of LaborSupervisory Wage and Hour InvestigatorWashington, DC$107,446–$139,684 / yearSupervisory/Managerial Qualities - Candidates must also demonstrate in their work experience that they possess at least three of the qualities listed below to successfully supervise/manage: Supervising/managing employees which includes evaluating performance, providing feedback, creating and managing workflow, and providing technical and administrative direction. Skill in analyzing written/verbal information and numerical data and making decisions on issues based on interviews, records review, reconstruction of missing or fraudulent records and applying legal or regulatory provisions, precedents, and principles to specific investigative matters.
QA Technical Writer/Investigator Workforce GeneticsQA Technical Writer/InvestigatorBaltimore, MarylandIn this role you will draft comprehensive deviation investigation reports, which includes conducting detailed root-cause investigations, manufacturing staff interviews, and interfacing with floor teams to clear the tactical backlog. Education: A formal academic degree is not strictly required; technical mastery, an ability to write cleanly under tight compliance timelines, and a strong history on the manufacturing floor are the primary drivers for selection.
Compliance Audit/Investigator - CCS / CPC / or CCA MedStar HealthCompliance Audit/Investigator - 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).
NewCriminal Investigator U.S. Department of LaborCriminal InvestigatorWashington, DC$147,899–$192,275 / yearMajor duties for this position include, but are not limited to the following: Conduct highly complex criminal investigations into threats directed towards the Department of Labor (DOL) leadership, particularly the Secretary of Labor and senior officials, as directed by the Secretary. DPO Criminal Investigator positions have the following training requirements: The incumbent must have attended an Acceptable federal law enforcement training equivalent to Federal Law Enforcement Training Center (FLETC) Criminal Investigative Training Program (CITP).