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Senior Compliance Investigator
Skills
Analytical SkillsFraud InvestigationsGEDHealth InsuranceHealthcareLeadershipManaged Care
What the job involves
The main requirements, responsibilities and hiring steps.
Requirements
- Bachelor's Degree in a related field or Associates with 5 years of applicable experience or High School/GED with 6 years of applicable experience may substitute for the Bachelor's Degree
- 4+ years of experience in investigations auditing and risk analysis
- 1+ year of experience reading analyzing and interpreting State and Federal laws rules and regulations
Nice to have
- Analytical
- Detail-oriented
- Cross-functional collaboration
- Leadership
- Investigative mindset
Day to day
- Lead compliance and ethics investigations across business units and health plans with a structured and defensible approach.
- Assess allegations, review documents, interview witnesses, analyze facts, and produce clear investigation reports with recommended actions.
- Collaborate closely with Legal People Relations SIU Privacy Finance and business leaders to track risks communicate findings and support remediation.