Senior Fraud Investigator - Medicare Job at Peraton, United States

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  • 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. Salary is determined by various factors, including but not limited to, the scope and responsibilities of the position, the individual’s experience, education, knowledge, skills, and competencies, as well as geographic location and business and contract considerations. Depending on the position, employees may be eligible for overtime, shift differential, and a discretionary bonus in addition to base pay.

EEO

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

Job Tags

Contract work, For contractors, Work at office, Remote work, Shift work,

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