Senior Fraud Investigator - Medicare Job at Peraton, United States

TTUxdS9vMnI0QmVQQVkvQ00rNVY1Y2Z2MHc9PQ==
  • Peraton
  • United States

Job Description

Responsibilities

SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.

SGS is seeking an experienced and highly skilled Senior Fraud Investigator . Ideal candidates will bring advanced investigative expertise with a strong focus on complex healthcare fraud investigations. This role requires individuals who can contribute subject matter expertise, mentor team members, and proactively identify emerging fraud trends in the healthcare sector.

What you'll do:

  • Conduct and support complex investigations into healthcare fraud, waste, and abuse, leveraging extensive experience with Medicare Administrative Contractors (MACs), federal healthcare contracts, state healthcare fraud investigative units, and/or agencies such as the Attorney General’s Office, HHS-OIG, or FBI.
  • Provide subject matter expertise and guidance to team members, serving as a mentor and resource for developing investigative skills.
  • Utilize an in-depth understanding of the healthcare industry to proactively detect, analyze, and address new fraud schemes and trends.
  • Collaborate with internal teams and external partners to ensure the integrity of healthcare programs and enhance investigative outcomes.
  • Telework available from Southeast Untied States, residency in FL preferred

Qualifications

Basic Qualifications:

  • 5 years with BS/BA; 3 years with MS/MA; 0 years with PhD
  • Demonstrated experience conducting complex fraud investigations within federal, state, or contractor environments.
  • Prior work with organizations such as MACs, HHS-OIG, FBI, state Attorney General offices, or similar investigative entities.
  • Strong analytical and critical thinking skills, with the ability to interpret and synthesize large volumes of data.
  • Proven ability to mentor and train investigative teams.
  • Knowledge and understanding of the healthcare industry and fraud landscape.
  • U.S. citizenship required
  • Telework available from Southeast Untied States, residency in FL preferred

Desirable Qualifications:

The most competitive candidates will have:

  • Prior leadership or supervisory experience in healthcare fraud investigations.
  • Familiarity with federal and state healthcare regulations and compliance requirements.

Peraton Overview

Peraton is a next-generation national security company that drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world’s leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies. Peraton operates at the critical nexus between traditional and nontraditional threats across all domains: land, sea, space, air, and cyberspace. The company serves as a valued partner to essential government agencies and supports every branch of the U.S. armed forces. Each day, our employees do the can’t be done by solving the most daunting challenges facing our customers. Visit peraton.com to learn how we’re keeping people around the world safe and secure.

Target Salary Range

$66,000 - $106,000. This represents the typical salary range for this position based on experience and other factors.

EEO

EEO: Equal opportunity employer, including disability and protected veterans, or other characteristics protected by law.

Job Tags

For contractors, Work at office, Remote work,

Similar Jobs

people resources

General Manager Job at people resources

 ...Manager's Competitive salary from 45k -65k with a fantastic monthly bonus structure! The company offer full medical benefits, life insurance, paid vacation, and 401K This company has had a proven growth and no signs of stopping any time soon! The ideal candidate... 

American Income Life

Remote Entry-Level Benefits Intake Agent Job at American Income Life

 ...currently only hiring U.S. residents who are legally authorized to work in the United States with a social security # (US Only). We are not hiring in...  ...Our Legacy: Protecting Families Since 1951 Work from Home Opportunity! Step into our legacy of serving working-... 

Elevance Health

Investigator I - Payment Integrity SIU Job at Elevance Health

**Investigator I****Carelon Payment Integrity** is a proud member of the Elevance Health family...  ..., which would provide an equivalent background.**Preferred Skills, Capabilities and...  ...race, or any other category protected by federal, state, and local pay equity laws _._*... 

EAG Automotive

Sales Consultant - Spanish speaking Job at EAG Automotive

 ...Sales Consultant Automotive WE ARE SEEKING A FLUENT SPANISH SALES CONSULTANT If youre ready to kick your sales career into overdrive, now is the perfect time to join our team of automotive sales professionals. This is an opportunity for you to turn your sales... 

Dan Wolf Automotive Group

License & Title Clerk Job at Dan Wolf Automotive Group

The Dan Wolf Automotive Group is looking for an experienced License & Title Clerk to join organization! If you have a passion for accuracy, understand title processing, and have a strong willingness to learn and grow, we want to hear from you.This full-time role works...