Supervisor - Audit/Investigation
Core
Lead audit and investigation activities to identify and address Medicare and Medicaid fraud, waste, abuse, and compliance issues while overseeing a team of auditors and investigators.
Role type
Senior IC supervisor (healthcare program integrity)
Builds
Administrative or legal actions against providers for fraud, waste, and abuse
Domain
Healthcare + Regulatory Compliance
Deliverable
client delivery
Required skills
Medicare/Medicaid processes, investigative judgment, case strategy development, team supervision, regulatory engagement, data analysis, stakeholder coordination, quality assurance, administrative remedies management
Preferred skills
CFE or AHFI certification, 8-11 years experience
Technologies
CMS systems, FOIA request platforms
Responsibilities
Review and assign audit/investigation cases based on workload and program requirements; Conduct onsite audits, interviews, and site verifications; Lead complex projects by developing strategies and coordinating stakeholder meetings; Evaluate investigative findings and approve case decisions; Prepare cases for Major Case Coordination and legal/administrative proceedings; Manage team performance through feedback, coaching, and professional development; Collaborate with law enforcement, data teams, and medical reviewers; Submit documentation for internal/external stakeholders including CMS and FOIA requests.
Seniority
Senior, hands-on IC with team leadership