Investigations Team Lead

Peraton; Herndon (VA); A distancia; USD 66.000 - 106.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, vision

401(k) with company match

Paid time off and holidays

Descripción de la vacante

Peraton is seeking an Investigations Team Lead to oversee SGS investigations, mentor staff, and ensure quality and timely completion of cases. The role includes coordinating case development for law enforcement referrals and maintaining workflow through monthly reviews.

Strong investigative experience and US citizenship are required, with telework options across US time zones. The position emphasizes leadership, policy-driven judgment, and the ability to direct staff toward high-quality outcomes

Formación

• Minimum of 8 years with BS/BA or 12 years with a HS Diploma/equivalent.
• Relevant investigative experience required.
• CFE or AHFI certification preferred.
• US citizenship required.

Responsabilidades

• Achieve quality objectives and oversee workload for investigations.
• Mentor investigative team and provide guidance.
• Lead case development for referral to law enforcement.
• Monitor case timeliness and QC for staff.
• Telework available from EST, CST, MST.

Conocimientos

Communication skills

Organization skills

PC knowledge

Educación

BS/BA degree

HS Diploma/equivalent

Descripción del empleo

Investigations Team Lead

Job Locations

US

Peraton Overview

Peraton is a next-generation national security company that drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world's leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies. Peraton operates at the critical nexus between traditional and nontraditional threats across all domains: land, sea, space, air, and cyberspace. The company serves as a valued partner to essential government agencies and supports every branch of the U.S. armed forces. Each day, our employees do the can't be done by solving the most daunting challenges facing our customers. Visit peraton.com to learn how we're keeping people around the world safe and secure.

Responsibilities

SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.

We are looking to add an Investigative Team Lead to our SGS team of talented professionals.

What You'll do:

As an Investigative Team Lead, this individual's primary responsibilities include achieving quality objectives, workload oversight to promote timely development and resolution of investigations and development of cases for referral to law enforcement or other entities and provide mentoring and guidance to investigative team. The individual exercises significant independent judgment within broadly defined policies and practices to determine the best method for accomplishing work and achieving objectives.

There may be multiple of these individuals for a task order and they may lead significantly different activities

• Act as a point of contact for manager
• Assist team members with workflow development
• Review individual workload during monthly meetings; assist with prioritization and conduct QC for staff
• Monitor the quality of UCM/WMM
• Monitor timeliness for case updates and escalating to management as necessary
• Monitor the progress of investigations and cases to ensure use of all available remedies, i.e., suspension, pre-pay reviews, revocation, etc.
• Mentor team members so that they can identify previously undetected fraud, waste, or abuse through proactive or reactive research, analysis, and development.
• Telework available from EST, CST. MST Time Zone

Qualifications

Basic Qualifications:

• Minimum of 8 years with BS/BA or 12 years with a HS Diploma/equivalent
• Relevant investigative experience required.
• CFE or AHFI certification preferred
• Strong communication and organization skills
• Strong PC knowledge and skills
• US. citizenship required

Preferred Qualifications:

• Knowledge of Medicare requirements, laws, rules and regulations related to payment for services billed the Program
• Experience in reviewing claims, performing medical review, and/or developing fraud cases

Essential Functions:

• Ability to perform research and draw conclusions
• Ability to present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government
• Ability to organize a case file, accurately and thoroughly document all steps taken
• Ability to compose correspondence, reports and referral summary letters
• Ability to educate providers, provider associations, law enforcement, other contractors and beneficiary advocacy groups on program safeguard matters
• Ability to communicate effectively, internally and externally
• Ability to interpret laws and regulations
• Ability to handle confidential material
• Ability to report work activity on a timely basis
• Ability to work independently and as a member of a team to deliver high quality work
• Ability to attend meetings, training, and conferences, overnight travel required
• Document QC results in WMM according to record type
• Coordinate with other designated leads if necessary, for coverage for periods where the lead is out of the office during work hours.

Target Salary Range

$66,000 - $106,000. This represents the typical salary range for this position. Salary is determined by various factors, including but not limited to, the scope and responsibilities of the position, the individual's experience, education, knowledge, skills, and competencies, as well as geographic location and business and contract considerations. Depending on the position, employees may be eligible for overtime, shift differential, and a discretionary bonus in addition to base pay.

Benefits Statement

Peraton offers eligible employees a variety of benefits including medical, dental, vision, life, health savings account, short/long term disability, EAP, parental leave, 401(k), paid time off (PTO) for vacation, and company paid holidays. A full listing of available benefits can be viewed at https://www.careers.peraton.com/benefits.

EEO

EEO: Equal opportunity employer, including disability and protected veterans, or other characteristics protected by law.