Senior Compliance Investigator

UCLA Outpatient Clinics; Los Angeles (CA); On-site; USD 115,000 - 165,000; Full time

Job summary

UCLA Outpatient Clinics is seeking a Senior Compliance Investigator in Los Angeles to lead complex compliance investigations regarding potential regulatory concerns. The role involves gathering and analyzing evidence, conducting interviews, and preparing comprehensive investigative reports. With a focus on integrity and regulatory compliance, the investigator will collaborate with various stakeholders. The anticipated hiring range is between $115,000 to $165,000 based on experience and qualifications, reflecting the high impact of this role.

Qualifications

• 5+ years of experience in compliance or regulatory investigations.
• Strong understanding of federal and state healthcare regulations.
• Ability to conduct sensitive interviews with professionalism.

Responsibilities

• Lead investigations into compliance concerns like fraud and abuse.
• Gather and analyze evidence effectively to support findings.
• Prepare detailed investigative reports outlining findings and actions.

Skills

Compliance investigations

Regulatory accountability

Evidence analysis

Interview skills

Report writing

Stakeholder partnership

Job description

Description

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.