Part D Senior Investigator

Attain Talent; United States; À distance; USD 90 000 - 110 000; Plein temps

Avantages offerts par ce poste

Medical, dental, vision coverage

Telehealth services

Paid time off 3.5 weeks + 11 holidays

401(k) with up to 4% match

Life and disability insurance

Tuition reimbursement up to $1,500/yr

Employee Assistance Program

Résumé du poste

Attain Talent seeks a Part D Sr Investigator to support federal healthcare program integrity through rigorous investigations and compliance oversight. You will review pharmacies and manufacturers, analyze data, and draft clear findings. Collaboration with CMS, OIG, and legal teams is essential.

The role demands strong investigative, analytical, and project-management skills, plus the ability to mentor junior staff and guide investigations toward timely, quality outcomes.

Qualifications

• Knowledge of Medicare Part D, drug pricing, and government pricing programs.
• Strong analytical and investigative skills with experience presenting findings.
• Familiarity with federal healthcare regulations related to pricing and compliance.
• Excellent written and verbal communication; ability to convey complex results to varied audiences.
• Solid project management skills and ability to handle multiple investigations.

Responsabilités

• Support investigation leads by reviewing dispensers, pharmacies, and manufacturers.
• Develop compliance requirements and investigation processes for timely, unbiased reviews.
• Draft investigation plans, memoranda, and final reports with actionable findings.
• Coordinate with CMS, OIG, and other bodies on escalated matters requiring action.
• Mentor junior staff and serve as SME for investigative techniques and program integrity.

Connaissances

Analytical skills

Investigative skills

Medicare Part D knowledge

Federal healthcare regulations

Communication skills

Project management

Data analysis

Mentoring SME

Formation

Bachelor’s degree + 5 years of relevant experience

Associates degree + 8 years of relevant experience

High school diploma + 9 years of relevant experience

Outils

Case management systems

E-discovery tools

Data analytics platforms

Description du poste

Attain Talent seeks a Part D Sr Investigator to support the integrity and effectiveness of federal healthcare programs through rigorous investigations, compliance oversight, and risk assessment. This role will support the review of pharmacies, dispensers, and manufacturers; develop investigative strategies and compliance processes; analyze data and evidence; and produce clear, actionable findings. The ideal candidate combines expertise in Medicare Part D, pharmaceutical pricing, and federal healthcare regulations with strong analytical, investigative, communication, and project management skills. This position will also collaborate with CMS, OIG, legal, audit, and other stakeholders while serving as a subject matter expert and mentor to support consistent, high-quality program integrity efforts.

Key Responsibilities

• Support the Investigation Lead with functions of the task order, including the review of dispensers, pharmacies, and manufacturers’ practices to ensure adherence to Negotiation Program requirements.
• Assist in the development of all necessary compliance requirements to inform compliance, investigations, reporting, and market surveillance activities.
• Assist in developing necessary investigation processes to ensure implementation of timely, thorough, and unbiased investigations.
• Assist in developing an investigation strategy and approach to ensure investigations are completed in accordance with program timelines and quality standards.
• Identify and assess potential risks or violations through data analysis, stakeholder interviews, audits, and tips received through oversight channels.
• Assist with intake, triage, and prioritization of investigative matters aligned with CMS compliance objectives.
• Collaborate with data analysts, auditors, compliance officers, legal experts, and other stakeholders to collect and assess evidence.
• Draft detailed investigation plans, memoranda, and final reports with actionable findings and recommendations.
• Coordinate with CMS, OIG, and other federal oversight bodies on escalated matters requiring enforcement or corrective action.
• Maintain a secure, documented chain of evidence throughout each case in compliance with federal guidelines.
• Establish and refine investigation protocols, SOPs, and escalation procedures in coordination with the complaint/dispute and auditing teams.
• Mentor junior staff and serve as subject matter expert (SME) related to investigative techniques and healthcare program integrity.

Qualifications

• Bachelor’s degree plus 5 years of relevant professional experience, or
• Associates degree plus 8 years of relevant professional experience, or
• High school diploma plus 9 years of relevant professional experience
• Demonstrated knowledge of Medicare Part D, drug pricing, manufacturer rebate structures, or government pricing programs.
• Strong analytical and investigative skills.
• Knowledge of federal healthcare regulations, especially those related to pharmaceutical pricing and compliance with government programs.
• Exceptional communication and writing skills, with ability to present complex findings to technical and non-technical audiences.
• Strong project management skills with the ability to manage multiple investigations simultaneously.
• Experience using case management systems, e-discovery tools, and data analytics platforms.
• Comprehensive medical, dental, and vision coverage, plus telehealth services and a confidential Employee Assistance Program.
• Paid time off starting at 3.5 weeks annually, increasing with tenure, plus 11 paid holidays.
• 401(k) retirement plan with an employer match of up to 4% of eligible compensation after six months of employment.
• Company-paid basic life, accidental death and dismemberment, and short- and long-term disability insurance.
• Professional development and tuition reimbursement programs, each offering up to $1,500 annually for eligible employees after six months of service, subject to approval.

Attain Talent is committed to fair and equitable compensation practices. The individual base salary for this position is unique to each candidate and will be commensurate with experience, education, and skills.

Interested in this position but the compensation isn’t quite right? Let us know your expectations, and we’ll see if we can make it happen based on your qualifications.

Salary Range

$90,000 - $110,000 USD

Attain Talent is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Voluntary Self-Identification

For government reporting purposes, we ask candidates to respond to the below self-identification survey.Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiringprocess or thereafter. Any information that you do provide will be recorded and maintained in aconfidential file.

As set forth in Attain Talent’s Equal Employment Opportunity policy,we do not discriminate on the basis of any protected group status under any applicable law.

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection.As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measurethe effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categoriesis as follows:

A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.

An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.