Senior Healthcare Fraud Investigator

Zachary Piper Solutions is seeking a Senior Healthcare Fraud Investigator to support a mission focused on protecting Veterans and taxpayer dollars through healthcare fraud prevention, program integrity, fraud risk management, and rapid-response oversight initiatives. This position is remote and candidates must be local to Washington, DC . The Senior Healthcare Fraud Investigator will lead healthcare fraud, waste, and abuse (FWA) lead development and case support efforts by transforming advanced analytics into decision-ready referral packages and investigative documentation. Join a high-visibility initiative that supports executive-level reporting and helps strengthen oversight of federal healthcare programs serving Veterans.

Responsibilities for the Senior Healthcare Fraud Investigator include:

• Review and validate anomalies, provider risk indicators, and prioritized leads generated through advanced analytics, provider profiling, and network analysis
• Develop healthcare fraud, waste, and abuse case documentation, referral packages, claim review workpapers, and supporting evidence packages
• Prepare weekly decision-ready case packages containing findings, analysis, recommendations, and traceable supporting documentation
• Support development of case management workflows, intake and triage SOPs, investigation templates, tracking registers, and case lifecycle processes
• Collaborate with program stakeholders and support leadership briefings, white papers, training materials, after-action reviews, and knowledge transfer activities

Required Qualifications for the Senior Healthcare Fraud Investigator include:

• 8+ years of experience supporting federal healthcare fraud investigations, healthcare program integrity, Medicare, Medicaid, or healthcare fraud case development efforts
• Working knowledge of healthcare fraud regulations including the False Claims Act, Anti-Kickback Statute, Stark Law, Civil Monetary Penalties Law, and healthcare exclusion authorities
• Strong analytical, investigative, documentation, and executive-level communication skills
• Bachelor's degree in a relevant field
• Ability to pass or currently hold a Tier 2 / Moderate Background Investigation (MBI)

Compensation for the Senior Healthcare Fraud Investigator include:

• Salary Range: $115,000 annually depending on experience
• Full Benefits Package: PTO, Paid Holidays, Medical, Dental, Vision, 401K, Tuition Reimbursement, Sick Leave as required by law

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