Lead Investigator - Special Investigations Unit

Lead Investigator - Special Investigations Unit

What you can expect! Find joy in serving others with IEHP. We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience.

Responsibilities and Qualifications The Lead Investigator is responsible for investigating and resolving high complexity allegations of healthcare Fraud, Waste and Abuse (FWA) by medical professionals, facilities and members. The position researches, gathers and analyzes data to identify trends, patterns, aberrancies and outliers in provider billing behavior. The incumbent serves as a subject matter expert for other investigators and works collaboratively within the Plan to ensure proper oversight of IEHP's FWA Programs. Key qualifications include comprehensive knowledge of managed care and Medicare programs, strong analytical and project management skills, excellent communication skills, proficiency in Microsoft Office and data analytics, and proven ability to lead a team and manage multi-tasks.

Perks

• Competitive salary
• Hybrid schedule
• CalPERS retirement
• State-of-the-art fitness center on-site
• Medical, dental and vision insurance
• Life, short-term and long-term disability coverage
• Career advancement and professional development opportunities
• Wellness programs promoting a healthy work-life balance
• Flexible Spending Account for health care and childcare
• 457(b) plan with contribution match
• Pet care insurance

Education & Requirements

Pay Range

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