Senior Investigator

🔥 12 hours ago

⚔️ Virginia – Remote

⚔️ Virginia – Remote

💵 $45k - $65k / year

⏰ Full Time

🟠 Senior

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Integrity Management Services, Inc.

WebsiteLinkedInAll Job Openings

51 - 200 employees

💼 Consulting

🏥 Healthcare

🛡️ Insurance

Consulting • Healthcare • Insurance

Integrity Management Services, Inc. is a women-owned, women-run company specializing in helping government and commercial enterprises minimize the risk of improper payments, fraud, waste, and abuse. The company provides a range of services including data analytics, fraud investigations, compliance reviews, audits, grants management, staff augmentation, and coding and medical reviews. IntegrityM, as they are known, works closely with Federal Government agencies, state agencies, and private sector organizations to drive informed decisions and enhance program transparency and oversight. The company is recognized for its contributions to the community and has been awarded for excellence in government contracting and corporate social responsibility.

📋 Description

• Conduct background research regarding individuals, organizations, or entities under review • Conduct investigations involving potential fraud, waste, and abuse • Analyze healthcare and operational data to identify trends, anomalies, and potential fraud indicators • Review applicable laws, regulations, policies, and guidance • Collect, review, and analyze investigation records and documentation • Conduct interviews and maintain accountability for evidentiary materials • Document investigative findings and prepare reports and recommendations • Coordinate with internal staff, legal counsel, government stakeholders, and law enforcement agencies • Collaborate with investigators, analysts, program managers, and subject matter experts to develop strategies and resolve cases • Enter and maintain information in case management and tracking systems • Present findings and recommendations to management and clients • Identify emerging fraud schemes and recommend investigative priorities • Prepare recurring and ad hoc reports on investigative activities and case status • Meet quality standards and project deadlines

🎯 Requirements

• Bachelor's degree in criminal justice, law enforcement, healthcare administration, data analysis, or a related field, or equivalent combination of education and relevant experience • Two or more years of experience supporting healthcare program integrity, fraud investigations, Medicare, Medicaid, commercial healthcare, or other government healthcare programs • Experience conducting fraud, waste, and abuse investigations preferred • Strong investigative, analytical, and problem-solving skills • Experience reviewing healthcare claims, enrollment records, medical records, or other complex documentation • Experience analyzing complex data and identifying patterns or anomalies • Strong written, verbal, and interpersonal communication skills • Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud Investigator (AHFI) preferred (or may be required based on contract requirements) • Ability to maintain confidentiality and exercise sound judgment • Ability to work independently and collaboratively within a team environment • Strong organizational skills with the ability to prioritize multiple assignments and meet deadlines • Proficiency with Microsoft Office applications, including Word and Excel • Passion for supporting healthcare program integrity and IntegrityM's mission, vision, and values

🏖️ Benefits

• Vacation • Sick leave • Paid holidays • Health insurance • Dental insurance • Vision insurance • Short- and long-term disability • Life insurance • Employee assistance plan • 401(K) retirement plan • Educational benefits • Flexible workplace • Professional development opportunities