Job Description

• Independently leads and conducts compliance investigations, including, but not limited to, assessment of allegations, review of relevant documents, witness interviews and written summaries of same, analysis of facts, and preparation of investigation reports.
• Conduct forensic analyses on a variety of source data in the context of fraud, embezzlement, corruption or money laundering investigations to come up with analytically sound findings which you can translate to a non-financial audience.
• Independently conducting fact-finding and confrontational interviews with both junior and senior-level employees, preparing concise and factual investigation reports and ad hoc briefing documents, advising on appropriate remedial actions as well as monitoring the implementation of these in response to investigations
• Utilize subject matter expertise in the areas of healthcare laws and compliance to support the business.
• Accountable for outstanding customer service to all external and internal customers.
• Develops and maintains effective relationships through effective and timely communication.
• Assists with the implementation, and continuous monitoring of an enterprise-wide Compliance Investigations Program.
• Adheres to Compliance Investigation work plans and protocols, assembles and manages the necessary internal and external resources, and conducts the investigation in compliance with protocols.
• Provides timely reports, both orally and in writing, to the Director of Compliance Investigations and/or senior management regarding the status of investigations.
• Provides input into investigation best practices and recommendations for continuous improvement to the Compliance Investigation Program.
• Collaborates with other departments, including the Finance, Human Resources, and Patient Care on investigations and the investigation process.
• Maintains current knowledge of laws, regulations and market changes that impact all aspects of the business, including, but not limited to, FCPA, Stark Law, Anti-Kickback Statute, Patient Inducement Statute, Health Insurance Portability and Accountability Act, relevant Office of Inspector General, Model Guidance, and applicable advisory opinions.
• Complies with the Code of Business Conduct and all applicable company policies and procedures, local, state and federal laws and regulations while maintaining the highest degree of personal ethics and integrity.
• Assist with various projects as assigned by Director of Compliance Investigations.
• Other duties as assigned.