Lead SIU Investigator Centene Management CompanyLead SIU InvestigatorWashingtonRemoteProvides direction and guidance to staff who investigate and remediate compliance and fraud, waste, and abuse related matters; while maintaining an investigative workload of moderate to high complexity. Bachelor's Degree in related field; or Associate's degree with 6 years related experience; or High School Diploma/GED with 7 years related experience.
Principle Employee Relations Investigator RadNetPrinciple Employee Relations InvestigatorMaryland$80,000–$90,000 / yearFull timeWhen you join RadNet as an Principle Employee Relations Investigator , you will be joining a dedicated team of professionals who deliver quality, value, and access in the 21 st century and align all stakeholders- patients, providers, payors, and regulators to achieve the best clinical outcomes. Partner closely with Legal, Compliance, HRBPs, and Operations leadership to ensure investigative practices are aligned with company policy, internal protocols, and applicable federal and state laws.
Investigator American OversightInvestigatorWashington, DCRemoteFull timeConduct rigorous review of document productions to identify key facts, patterns, inconsistencies, and gaps; analyze documents in context to surface unreported insights and emerging trends, and synthesize findings into clear, accurate, and strategically useful outputs such as newsworthy narratives that advance government accountability or actionable insights that equip partners’ advocacy and litigation. Monitor news and track other sources to identify emerging issues where American Oversight’s investigations can have the greatest impact, and proactively propose strategic, high-impact ideas that leverage public records and open-source intelligence.
Health System Specialist (Corporate Compliance Investigator Coordinator) U.S. Department of Veterans AffairsHealth System Specialist (Corporate Compliance Investigator Coordinator)Washington, DC$81,186–$105,547 / yearSuch a training program must have been conducted in an operating health care system and included: Assignments providing a knowledge of basic health system administration philosophies, practices, and procedures, and basic government administrative policies and requirements; Practical assignments providing an opportunity to apply health system administration skills and principles (as the individual progresses, work assignments must be characteristic of the grade level to which he or she is assigned); and. Duties may include but are not limited to: CCIC coordinates, determines, evaluates, and conducts assessments for investigation(s) and/or fact finding(s) regarding Administrative Investigative Boards (AIBs) related to both clinical and non-clinical issues and, upon approval of the Director, will organize and implement investigation(s) and/or fact finding(s) AIB actions.
NewCriminal Investigator (Reemployed Annuitant and ICTAP eligibles) U.S. Department of Homeland SecurityCriminal Investigator (Reemployed Annuitant and ICTAP eligibles)Washington, DC$90,925–$118,204 / yearApplicants must demonstrate that they meet the Minimum Qualification requirements as listed below: You qualify for the GS-13 level (starting base salary $90,925.00) if you possess at least one year of specialized experience equivalent to the GS-12 level, performing duties such as: Executing protection assignments for high-profile individuals, facilities, and sensitive operation. Operating designated security posts at official or social functions attended by protectees; restricting access to closed areas, ensuring only authorized persons enter; and coordinating the collection, evaluation, and analysis of extensive and often conflicting intelligence information gathered through a wide variety of sources (e.g.
Sub-Investigator Care AccessSub-InvestigatorBaltimore, Maryland$120,000–$150,000 / yearWith programs like Future of Medicine , which makes advanced health screenings and research opportunities accessible to communities worldwide, and Difference Makers , which supports local leaders to expand their community health and wellbeing efforts, we put people at the heart of medical progress. Perform trial procedures as per delegation which can include the following but not limited to: Prescreen study candidates by telephone and review exclusionary conditions or medications prior to scheduling screening appointment.
Sub Investigator Care AccessSub InvestigatorArlington, VA$120,000–$150,000 / yearWith programs like Future of Medicine, which makes advanced health screenings and research opportunities accessible to communities worldwide, and Difference Makers, which supports local leaders to expand their community health and wellbeing efforts, we put people at the heart of medical progress. Perform trial procedures as per delegation which can include the following but not limited to: Prescreen study candidates by telephone and review exclusionary conditions or medications prior to scheduling screening appointment.
Senior 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.
CRIMINAL INVESTIGATOR U.S. Department of DefenseCRIMINAL INVESTIGATORWashington, DC$121,785–$158,322 / yearApplicants must meet the agency's conditions of employment, to include, but not limited to, satisfactory completion of an initial special background investigation and periodic reinvestigation, completion of any required medical examination and physical requirements, completion of any required personal interviews, favorable completion of any required initial or aperiodic polygraph examinations, completion of any required drug test, satisfactory completion of a two-year Defense Civilian Intelligence Personnel System trial period, and completion of a civilian mobility agreement. All positions in the Defense Intelligence Agency are in the excepted service under 10 USC 1601 appointment authority and covered by the Defense Civilian Intelligence Personnel System (DCIPS), a General Grade (GG) pay system divided into grades and steps similar to OPM's General Schedule (GS) compensation system.
Fraud Investigator EagleBankFraud InvestigatorSilver Spring, Maryland$69,844–$108,847 / yearFull timeRequires direct and productive interaction with the Fraud Investigations Manager, BSA/AML, clients, and other fraud personnel within financial services organizations entities, and federal/local/state law enforcement agencies. Responsibilities: The Fraud Investigator develops and conducts fraud investigations, monitors and dispositions fraud alerts, and mitigates financial losses through asset recovery for EagleBank Corp.
Background Investigator Military, Veterans and Diverse Job SeekersBackground InvestigatorMarylandDiploma or equivalent; Minimum of One (1) year within the last ten (10) years of investigations experience at the federal, state, or local level of government; Experience conducting one-on-one subject interviews is required; Reliable personal vehicle, valid driver's license, and satisfactory driving record; Willing to travel on temporary duty assignments as needed (by car or plane); Successfully pass background checks and all required training; Current (within the last 2 years) Single Scope Background Investigation (SSBI) or active Secret level security clearance based on an SSBI and able to obtain the required security clearance. Work cases throughout the geographic area of responsibility and travel to various places of employment, residence and education institutions.
Investigator (OIG Auditor) - Mid to Expert Level (Maryland) U.S. Department of DefenseInvestigator (OIG Auditor) - Mid to Expert Level (Maryland)Maryland, MD$85,447–$197,200 / yearEntry is with a high school diploma or GED plus 13 years of relevant experience, or an Associates degree plus 11 years of relevant experience, or a Bachelors degree plus 9 years of relevant experience, or a Masters degree plus 7 years of relevant experience, or a Doctoral degree plus 5 years of relevant experience. Entry is with a high school diploma or GED plus 10 years of relevant experience, or an Associates degree plus 8 years of relevant experience, or a Bachelors degree plus 6 years of relevant experience, or a Masters degree plus 4 years of relevant experience, or a Doctoral degree plus 2 years of relevant experience.
Fraud Investigator KoalafiFraud InvestigatorArlington, VARemote$61,000–$74,000 / yearFraud Investigators have several tools available to assist in their research, such as application data, internal system of record data, internet search data, and third-party fraud prevention tools. Leverage tools such as application data, internal system of record data, internet search data, and third-party fraud prevention tools to reach accurate investigation conclusions.
NewProgram Integrity Investigator (Healthcare Fraud Waste & Abuse) TriWest Healthcare AllianceProgram Integrity Investigator (Healthcare Fraud Waste & Abuse)Baltimore, MDRemoteFull timeComplies with the Veterans Affairs Community Care Network (CCN) and TRICARE T-5 contracts; DHA and TRICARE program guidelines and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, Military members and family (as warranted), providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals. The PI Investigator t is responsible for the identification, analysis, case development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA), the Healthcare Finance Administration (HCFA) and the Department of Defense, Defense Health Agency for the TRICARE program; requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).
Retail Crime Investigator Weis MarketsRetail Crime InvestigatorMarylandThe requirements listed below are representative of the knowledge, skills, and/or abilities required: Bachelor's degree (BA/BS) Criminal Justice, Criminology, Business, or related field preferred, plus one (1) year retail loss prevention experience in a retail store environment. The associate is responsible for the functions below, in addition to other duties as assigned: Investigate and resolve external theft (Shoplifting, Organized Retail Crime, etc.).
Compliance Audit/Investigator - CCS / CPC / or CCA MedStar Health Research InstituteCompliance Audit/Investigator - CCS / CPC / or CCADC$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).
NewSmoking 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.
Compliance Audit / Investigator / Coder - CCS / CPC / or CCA MedStar HealthCompliance Audit / Investigator / Coder - CCS / CPC / or CCAWashington, DC$65,062–$117,291 / yearFull timePerforms 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).
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).