Senior Compliance Investigator

Office of
Compliance Services

Support a
high-impact compliance investigation function focused on integrity, risk
mitigation, and regulatory accountability. The Senior Compliance Investigator leads
and conducts compliance investigations involving potential regulatory concerns,
including fraud, waste, abuse, and violations of federal and state regulations
and UC and organizational policies. This role involves gathering and analyzing
evidence, conducting interviews, preparing investigative reports, monitoring
corrective actions, and partnering with stakeholders to strengthen compliance
across the enterprise.

In this
role, you will:

• Lead and conduct complex compliance investigations
  of reported compliance concerns, involving fraud, waste, abuse, and policy
  violations.
• Gather, analyze, and evaluate evidence, including
  documents, data, and records, to support investigative findings.
• Conduct Interviews with employees, patients, and
  external parties, exercising professionalism and discretion in sensitive
  situations.
• Prepare clear, detailed investigative reports
  that outline findings, conclusions, and recommended corrective actions.
• Partner with Legal Affairs, Risk Management,
  Human Resources, and other stakeholders on investigation outcomes.
• Monitor and evaluate corrective actions to
  ensure effective resolution.
• Stay current with federal and state healthcare
  regulations, enforcement trends, and compliance best practices.
• Support the development and delivery of compliance
  training and education informed by investigation findings.
• Identify trends and emerging risks based on
  investigation findings and contribute to broader compliance risk assessments,
  as well as the enhancement of departmental investigative processes and tools.
• Maintain thorough, accurate, and confidential
  investigation records in compliance tracking systems and databases.

Salary
Range:

The full salary
range for this position is $105,700 to $234,500,
with an anticipated hiring range between $115,000 to $165,000, depending on
qualifications and experience.

Required

• Bachelor's degree from an accredited academic
  institution or equivalent experience.
• Minimum of seven years of experience conducting
  investigations, preferably within a healthcare setting or involving healthcare
  compliance matters.
• Strong knowledge of federal and state healthcare
  regulations, including Stark Law, Anti-Kickback Statute, and related laws.
• Demonstrated experience leading investigations,
  interviewing witnesses, analyzing evidence, preparing investigation reports,
  and managing corrective action follow-up.
• Experience developing or contributing to educational
  content or compliance training materials.
• Strong analytical, problem-solving,
  critical-thinking, organizational, and communication skills.
• Ability to manage multiple investigations,
  competing priorities, and sensitive matters with sound judgment and
  professionalism.
• Ability to work effectively with senior
  management, staff, and cross-functional stakeholders in a complex environment.
• High level of integrity, ethical conduct, and
  commitment to maintaining confidentiality.
• Proficiency with Microsoft Office applications.
• Experience working with compliance tracking
  systems or databases and maintaining detailed documentation.

Preferred

• Advanced degree, such as a JD or Master's
  degree, is preferred.
• Prior experience as an investigator with a
  local, state, or federal law enforcement or regulatory agency, such as HHS OIG
  or FBI, is highly desirable.