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Senior Investigator
Attain Talent. Support the Investigation Lead with functions of the task order, including the review of dispensers, pharmacies, and manufacturers’ practices to ensure adherence to Negotiation Program requirements.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in investigative techniques and compliance with federal healthcare regulations, particularly in Medicare Part D and pharmaceutical pricing. Capable of managing multiple investigations while ensuring adherence to quality standards and program timelines.
Highest-signal resume keywords
Medicare Part D KnowledgeAnalytical SkillsInvestigative SkillsProject ManagementFederal Healthcare Regulations
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Data AnalysisInvestigation ProcessesCompliance DevelopmentRisk AssessmentReport Writing
Soft Skills
Communication SkillsMentoringCollaboration
Tools & Technologies
Case Management SystemsE-Discovery ToolsData Analytics Platforms
Industry Keywords
Pharmaceutical PricingGovernment Pricing ProgramsCompliance ObjectivesChain of EvidenceSOP Development
About the role
Key responsibilities & impact- Support the Investigation Lead with functions of the task order, including the review of dispensers, pharmacies, and manufacturers’ practices to ensure adherence to Negotiation Program requirements.
- Assist in developing compliance requirements for compliance, investigations, reporting, and market surveillance activities.
- Assist in developing investigation processes and strategies to ensure timely, thorough, unbiased investigations meeting program timelines and quality standards.
- Identify and assess potential risks or violations through data analysis, stakeholder interviews, audits, and oversight-channel tips.
- Assist with intake, triage, and prioritization of investigative matters aligned with CMS compliance objectives.
- Collaborate with data analysts, auditors, compliance officers, legal experts, and other stakeholders to collect and assess evidence.
- Draft investigation plans, memoranda, and final reports with actionable findings and recommendations.
- Coordinate with CMS, OIG, and other federal oversight bodies on escalated matters requiring enforcement or corrective action.
- Maintain a secure, documented chain of evidence throughout each case in compliance with federal guidelines.
- Establish and refine investigation protocols, SOPs, and escalation procedures with complaint/dispute and auditing teams.
- Mentor junior staff and serve as a subject matter expert in investigative techniques and healthcare program integrity.
Requirements
What you’ll need- Bachelor’s degree plus 5 years of relevant professional experience, or
- Associates degree plus 8 years of relevant professional experience, or
- High school diploma plus 9 years of relevant professional experience
- Demonstrated knowledge of Medicare Part D, drug pricing, manufacturer rebate structures, or government pricing programs.
- Strong analytical and investigative skills.
- Knowledge of federal healthcare regulations, especially those related to pharmaceutical pricing and compliance with government programs.
- Exceptional communication and writing skills, with ability to present complex findings to technical and non-technical audiences.
- Strong project management skills with the ability to manage multiple investigations simultaneously.
- Experience using case management systems, e-discovery tools, and data analytics platforms.
Benefits
Comp & perks- Comprehensive medical, dental, and vision coverage, plus telehealth services and a confidential Employee Assistance Program.
- Paid time off starting at 3.5 weeks annually, increasing with tenure, plus 11 paid holidays.
- 401(k) retirement plan with an employer match of up to 4% of eligible compensation after six months of employment.
- Company-paid basic life, accidental death and dismemberment, and short- and long-term disability insurance.
- Professional development and tuition reimbursement programs, each offering up to $1,500 annually for eligible employees after six months of service, subject to approval.