Supervisor – Audit/Investigation

🕒 June 18

🏈 Alabama, California, +36 more states – Remote

🏈 Alabama – Remote 🏄 California – Remote 🐊 Florida – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🌶️ New Mexico – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🌾 North Dakota – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote ⚔️ Virginia – Remote ☕ Washington – Remote ⛰️ West Virginia – Remote 🧀 Wisconsin – Remote 🦬 Wyoming – Remote

💵 $66.3k - $95k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

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Qlarant

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1973

🏛️ Government

⚕️ Healthcare Insurance

Government • Healthcare Insurance • Insurance & Financial Services

Qlarant is a US-based services and technology firm specializing in healthcare program integrity, offering quality improvement, fraud, waste & abuse (FWA) detection and investigative services, and advanced data analytics and predictive modeling tools (the RIViR® Risk Solution Suite) for government agencies, health plans, and related sectors. The company also operates initiatives like the Qlarant Foundation and Qlarant Capital to fund grants and early-stage startups, and provides pharmacy, drug pricing, and transportation-focused solutions.

📋 Description

• Oversees audits/investigations and audit/investigation workload • Performs in-depth evaluation and makes field level judgments related to audits/investigations of potential Medicare fraud waste and abuse audits/investigations or cases compliance cases • Reviews new audits/investigations and/or incoming leads • Reviews audit/investigation plans and priorities • Conducts file reviews regularly of audits/investigations • Reviews auditor/investigator requests for information, data, reports, and correspondence • Supervises and conducts audit/investigation actions • Leads audit/investigation projects • Communicates with the Data and Medical Review departments • Prepares and presents audits/investigations, overpayments, and questions for stakeholder meetings • Documents audit/investigation information and file reviews • Determines audit/investigation appropriateness of fraud, waste, and abuse issues • Reviews audit/investigative findings with auditors/investigators • Supervises and prepares team’s audits/investigations for Major Case Coordination meetings • Initiates and maintains communications with law enforcement and appropriate regulatory agencies • Supervises administrative remedies • Reviews and approves closing summary of audit/investigation • Collects information and documentation as requested by internal and external stakeholders • Collaborates with other program integrity contractors • Testifies at various legal or administrative proceedings • Manages team performance through regular, timely feedback

🎯 Requirements

• Minimum Bachelor's Degree required • 5 - 7 years of experience required; 8 - 11 years preferred • Certified Fraud Examiner or Accredited Healthcare Anti-fraud Investigator Certification preferred