Compliance Investigator

Health Care Service Corp.; Chicago (IL); Hybrid; USD 63,000 - 114,000; Full time

Job summary

Health Care Service Corporation seeks an investigator responsible for internal inquiries into misconduct or potential policy violations. You will prepare detailed reports and advise senior management on corrective action, including termination when warranted.

The role includes investigating moderate-risk areas and monitoring action plans across the organization. Responsibilities include guiding on conflicts of interest and interpretation of policies, with emphasis on compliance and governance

Qualifications

• Bachelor's degree required in Criminal Justice, Business, Health Care Administration or Human Resources with 3 years’ experience involving investigations or 7 years’ experience in investigations.
• Experience conducting internal investigations and interviewing individuals.
• Knowledge of HR policies and procedures.
• Knowledge of Federal and State employment laws.
• Strong verbal and written communication skills.
• Listening skills and ability to accurately document information.
• Strong organizational, decision-making and analytical skills.
• Proficiency in Word, Excel, and database applications.

Responsibilities

• Conduct internal investigations of misconduct or potential policy violations.
• Prepare detailed summary reports and recommend corrective actions up to termination.
• Investigate areas identified as moderate risk in risk assessments and monitor corrective actions.
• Provide guidance on conflicts of interest and interpretation of company policies.

Skills

Interviewing

HR policies understanding

Verbal and written communication

Listening and documentation

Organizational and analytical skills

Decision making

Education

Bachelor degree in Criminal Justice, Business, Health Care Administration, or Human Resources

Tools

Word

Excel

Database applications

Job description

Job Summary

This position is responsible for conducting internal investigations of concerns of misconduct or potential violations of the Code of Conduct and/or company policies; preparing detailed summary reports and making recommendations to senior management for corrective action, including disciplinary action up to and including termination; performing investigations and analyses on areas identified as moderate risk in the annual risk assessment and monitoring corrective action plans for HCSC and subsidiary operations; and providing guidance on conflicts of interest and interpretation of company policies.

Required Job Qualifications

• Bachelor Degree in Criminal Justice, Business, Health Care Administration, Human Resources with 3 years’ work experience involving researching and investigating inquiries OR 7 years’ work experience involving researching and investigating inquiries.
• Experience in conducting internal investigations and interviewing individuals.
• Understand HR policies and procedures.
• Knowledge of Federal and State employment laws.
• Verbal and written communication skills.
• Listening skills and ability to accurately document information reported.
• Organizational; decision-making and analytical skills.
• PC experience to include Word, Excel and database applications.

Preferred Job Qualifications

• Knowledge of corporate policies and organizational structure.
• Knowledge of the Corporate Integrity and Compliance Program and regulations.
• Certified Fraud Examiner (CFE) designation.
• Certified Compliance & Ethics Professional (CCEP) designation.
• Juris Doctorate, Paralegal or other legal experience.
• Familiarity with external governmental agencies (i.e., EEOC, Department of Human Rights etc.).

Job Details

This is a Flex (Hybrid) role: 3 days in office; 2 days remote.

Flex employees are expected to be in the office a minimum of three days a week. Management will have discretion to modify an employee's weekly schedule for exigent circumstances.

Base Pay Range $63,300.00 - $114,300.00 Exact compensation may vary based on skills, experience, and location.

This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

#LI-MM1 #LI-Hybrid

Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work.

From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees.

Equal Opportunity and Diversity

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

We are a drug-free and smoke-free workplace.

Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

Accommodations

If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations. Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process.

About HCSC

For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.

Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.