Base: $72,096 - $115,353; bonus/equity: not specif...
On-site
Investigate medical providers and members
Analyze data and contracts
Prepare investigative reports
The Sr. Investigator, Fraud, Waste & Abuse will support the detection, prevention, investigation, mitigation, and reporting of FWA issues, conducting end-to-end investigations from case management to resolution
Job Summary
The Sr. Investigator, Fraud, Waste & Abuse will support the detection, prevention, investigation, mitigation, and reporting of FWA issues, conducting end-to-end investigations from case management to resolution.
This position offers partial telework, requiring work within the State of California and a minimum of two days per week in the Orange, CA office.
The role includes competitive compensation with a hiring range of $72,096 - $115,353, a comprehensive benefits package, CalPERS pension, and opportunities for professional and career development.
Matching Summary
The Sr. Investigator, Fraud, Waste & Abuse will support the detection, prevention, investigation, mitigation, and reporting of FWA issues, conducting end-to-end investigations from case management to resolution.
Salary
Base: $72,096 - $115,353; Bonus/Equity: Not specified; Benefits: Comprehensive benefits package, CalPERS pension program, generous PTO, wellness programs, tuition reimbursement, professional development, career development, flexible scheduling
Skills & Requirements
Must-have
Investigate medical providers and members
Analyze data and contracts
Prepare investigative reports
Work with internal departments and external entities
Maintain accurate recordkeeping
Nice-to-have
Mission-driven culture
Collaborate with community partners
Advance career while making a difference
Build healthier communities
Key Requirements
Bachelor's degree in health care administration, criminal justice or related field
5 years of experience in health care-related investigations
Access to transportation for work away from office (approx. 15%)
Certified Fraud Examiner (CFE) or similar certification