Senior Compliance Investigator

DescriptionOffice ofCompliance ServicesSupport ahigh-impact compliance investigation function focused on integrity, riskmitigation, and regulatory accountability. The Senior Compliance Investigator leadsand conducts compliance investigations involving potential regulatory concerns,including fraud, waste, abuse, and violations of federal and state regulationsand UC and organizational policies. This role involves gathering and analyzingevidence, conducting interviews, preparing investigative reports, monitoringcorrective actions, and partnering with stakeholders to strengthen complianceacross the enterprise.In this role, you will:Lead and conduct complex compliance investigationsof reported compliance concerns, involving fraud, waste, abuse, and policyviolations.Gather, analyze, and evaluate evidence, includingdocuments, data, and records, to support investigative findings.Conduct Interviews with employees, patients, andexternal parties, exercising professionalism and discretion in sensitivesituations.Prepare clear, detailed investigative reportsthat outline findings, conclusions, and recommended corrective actions.Partner with Legal Affairs, Risk Management,Human Resources, and other stakeholders on investigation outcomes.Monitor and evaluate corrective actions toensure effective resolution.Stay current with federal and state healthcareregulations, enforcement trends, and compliance best practices.Support the development and delivery of compliancetraining and education informed by investigation findings.Identify trends and emerging risks based oninvestigation findings and contribute to broader compliance risk assessments,as well as the enhancement of departmental investigative processes and tools.Maintain thorough, accurate, and confidentialinvestigation records in compliance tracking systems and databases.Salary Range:The full salaryrange for this position is $105,700 to $234,500,with an anticipated hiring range between $115,000 to $165,000, depending onqualifications and experience.QualificationsRequiredBachelor's degree from an accredited academicinstitution or equivalent experience.Minimum of seven years of experience conductinginvestigations, preferably within a healthcare setting or involving healthcare compliance matters.Strong knowledge of federal and state healthcareregulations, including Stark Law, Anti-Kickback Statute, and related laws.Demonstrated experience leading investigations,interviewing witnesses, analyzing evidence, preparing investigation reports,and managing corrective action follow-up.Experience developing or contributing to educationalcontent or compliance training materials.Strong analytical, problem-solving,critical-thinking, organizational, and communication skills.Ability to manage multiple investigations,competing priorities, and sensitive matters with sound judgment andprofessionalism.Ability to work effectively with seniormanagement, staff, and cross-functional stakeholders in a complex environment.High level of integrity, ethical conduct, andcommitment to maintaining confidentiality.Proficiency with Microsoft Office applications.Experience working with compliance trackingsystems or databases and maintaining detailed documentation.PreferredAdvanced degree, such as a JD or Master'sdegree, is preferred.Prior experience as an investigator with alocal, state, or federal law enforcement or regulatory agency, such as HHS OIGor FBI, is highly desirable.J-18808-Ljbffr