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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