Senior Investigator
Integrity Management Services, Inc.
Posted: 10/21/2026
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Integrity Management Services, Inc.Posted 10/21/2026full-timeRemote • Virginia • United StatesSenior💰 $45,000 - $65,000 per yearWebsite
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in conducting fraud investigations and analyzing healthcare data to identify trends and anomalies. Proficient in preparing reports, collaborating with stakeholders, and maintaining confidentiality while supporting healthcare program integrity.
Highest-signal resume keywords
Fraud InvestigationsHealthcare Program IntegrityData AnalysisCertified Fraud Examiner (CFE)Strong Analytical Skills
About the role
Key responsibilities & impact- Conduct background research regarding individuals, organizations, or entities under review
- Conduct investigations involving potential fraud, waste, and abuse
- Analyze healthcare and operational data to identify trends, anomalies, and potential fraud indicators
- Review applicable laws, regulations, policies, and guidance
- Collect, review, and analyze investigation records and documentation
- Conduct interviews and maintain accountability for evidentiary materials
- Document investigative findings and prepare reports and recommendations
- Coordinate with internal staff, legal counsel, government stakeholders, and law enforcement agencies
- Collaborate with investigators, analysts, program managers, and subject matter experts to develop strategies and resolve cases
- Enter and maintain information in case management and tracking systems
- Present findings and recommendations to management and clients
- Identify emerging fraud schemes and recommend investigative priorities
- Prepare recurring and ad hoc reports on investigative activities and case status
- Meet quality standards and project deadlines
Requirements
What you’ll need- Bachelor's degree in criminal justice, law enforcement, healthcare administration, data analysis, or a related field, or equivalent combination of education and relevant experience
- Two or more years of experience supporting healthcare program integrity, fraud investigations, Medicare, Medicaid, commercial healthcare, or other government healthcare programs
- Experience conducting fraud, waste, and abuse investigations preferred
- Strong investigative, analytical, and problem-solving skills
- Experience reviewing healthcare claims, enrollment records, medical records, or other complex documentation
- Experience analyzing complex data and identifying patterns or anomalies
- Strong written, verbal, and interpersonal communication skills
- Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud Investigator (AHFI) preferred (or may be required based on contract requirements)
- Ability to maintain confidentiality and exercise sound judgment
- Ability to work independently and collaboratively within a team environment
- Strong organizational skills with the ability to prioritize multiple assignments and meet deadlines
- Proficiency with Microsoft Office applications, including Word and Excel
- Passion for supporting healthcare program integrity and IntegrityM's mission, vision, and values
Benefits
Comp & perks- Vacation
- Sick leave
- Paid holidays
- Health insurance
- Dental insurance
- Vision insurance
- Short- and long-term disability
- Life insurance
- Employee assistance plan
- 401(K) retirement plan
- Educational benefits
- Flexible workplace
- Professional development opportunities
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Investigative TechniquesData AnalysisHealthcare Claims ReviewPattern RecognitionReport PreparationDocumentation AnalysisInterviewing SkillsCase ManagementEvidentiary AccountabilityRegulatory Compliance
Soft Skills
Strong Communication SkillsProblem-Solving SkillsOrganizational SkillsTeam CollaborationConfidentiality Maintenance
Tools & Technologies
Microsoft OfficeCase Management SystemsTracking Systems
Certifications & Qualifications
Certified Fraud Examiner (CFE)Accredited Healthcare Fraud Investigator (AHFI)
Industry Keywords
FraudWasteAbuseMedicareMedicaidHealthcare AdministrationCriminal JusticeGovernment Healthcare ProgramsOperational Data AnalysisCompliance Standards