Top 561 Quality complaint investigator Jobs

Program Specialist II (Investigator II)
Galt Foundation —Oklahoma City, OK
- $25 an hour
- Contract
- Working with individuals with disabilities
- Mid-level
- Office
- Health insurance
Quick Apply
Quality Investigator
Medisca Inc. —Irving, TX
- Full-time
- Microsoft Excel
- Microsoft Outlook
- English
- Health savings account
- Paid holidays
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Investigator I - IV
State of Hawaii —Lihue, HI
- From $4,858 a month
- Email
- Background check
- Word processing
- Writing skills
- Mileage reimbursement
- Commuter assistance
Quick Apply
Investigator I - IV
State of Hawaii —Kailua-Kona, HI
- From $5,076 a month
- Email
- Background check
- Word processing
- Writing skills
- Mileage reimbursement
- Commuter assistance
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Investigator IV
State of Hawaii —Hilo, HI
- Email
- Background check
- Writing skills
- Driver's License
- Mileage reimbursement
- Commuter assistance
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Lead Ultrasound Tech-$15,000 Sign on Bonus
Boston Medical Center —Boston, MA
- $34.38 - $50.00 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Patient monitoring
- Health insurance
- Dental insurance
Safety and Wellness Advocate - Overnight
Passavant Memorial Homes —Pittsburgh, PA
- $47,000 - $60,000 a year
- Weekends as needed
- Mid-level
- Office
- Residential
- Health insurance
- Dental insurance
Quick Apply
Safety and Wellness Advocate
Passavant Memorial Homes —Pittsburgh, PA
- $47,000 - $60,000 a year
- Weekends as needed
- Mid-level
- Residential
- Driver's License
- Health insurance
- Dental insurance
Quick Apply
Lead Ultrasound Tech-$15,000 Sign on Bonus
Boston Medical Center —Boston, MA
- $34.38 - $50.00 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Patient monitoring
- Health insurance
- Dental insurance
Clinical Affairs Specialist III
Integer Holdings Corporation —Plano, TX
- Full-time
- Nursing
- Oracle
- 3 years
- Disability insurance
- Health insurance
Quick Apply
Clinical Research RN Coordinator - Clinical Research Institute - Full Time 8 Hours Day (Non-Union, Exempt)
Keck Medical Center of USC —Arcadia, CA
- $49.86 - $76.69 an hour
- 8 hour shift
- Background check
- Nursing
- RN License
Former FDA Investigator (Mock Inspection/Audit Consultant)
RQM+ —Remote
- Senior level
- Communication skills
- Ability to lift 25 pounds
Quick Apply
Senior Investigator
UnitedHealthcare —Dallas, TX
- $60,200 - $107,400 a year
- Full-time
- Remote
- Microsoft Word
- Pass drug screening
- Driver's License
- AD&D insurance
- Employee stock purchase plan
Board Investigator
NATIONAL BOARD FOR CERTIFIED COUNSELORS INC. —Greensboro, NC
- Weekends as needed
- Hybrid work
- English
- Research
- Mid-level
- Profit sharing
- Health savings account
Quick Apply
LTCR Nursing Facilities Investigator V
Health & Human Services Comm —Houston, TX
- $6,318.95 - $7,761.50 a month
- Online Application
- Nursing home
- Computer literacy
- Writing skills
- Health insurance
- 401(k)
Quick Apply
Quality Investigator
SCN BestCo —Santa Cruz, CA
- $66,980.88 - $100,471.32 a year
- Full-time
- Computer science
- Azure
- Computer Science
- Health insurance
- Dental insurance
Quick Apply
Investigator
INDEX ANALYTICS LLC —Windsor Mill, MD
- $59,850 - $76,650 a year
- Remote
- Mid-level
- Office
- Master's degree
- Health insurance
- Professional development assistance
9d
Investigator (Employee Discipline) Office of Investigations and Labor Relations, Division of the First Deputy Commissioner
HOUSING PRESERVATION & DVLPMNT —New York, NY
- $58,797 - $67,617 a year
- Full-time
- Writing skills
- Mid-level
- Office
- Loan forgiveness
Compliance Investigator
University of Central Florida —Orlando, FL
- $64,518 a year
- Full-time
- Mid-level
- Master's degree
- University
- Paid holidays
- Health insurance
9d
Program Integrity Investigator (Healthcare Fraud Waste & Abuse)
TriWest Healthcare Alliance —Phoenix, AZ
- $64,000 - $68,000 a year
- Full-time
- Research
- Mid-level
- High school diploma or GED
- AD&D insurance
- Disability insurance

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Program Specialist II (Investigator II)

Galt Foundation -
Oklahoma City, OK

Quick Apply

Job Details

Contract
$25 an hour

Benefits

Health insurance

Qualifications

Working with individuals with disabilities
Bachelor's degree
Working with individuals with intellectual disabilities
Stakeholder management

Full Job Description

Job Title: Program Specialist II (Investigator II)

Location: Oklahoma City, OK

Schedule: Monday - Friday, 8:00 am - 5:00 pm

Pay: $25.00 per hour

Job Overview:
Join a dedicated team committed to safeguarding the integrity of Medicaid programs as a Program Specialist II (Investigator II). In this vital role, you will conduct comprehensive investigations into potential policy violations, fraud, and discrepancies within the Medicaid system. Your work directly supports the agency’s mission to ensure access to quality health care for all Oklahomans by promoting transparency, accountability, and compliance with state and federal regulations. This position offers an opportunity to make a meaningful impact through detailed analysis, stakeholder collaboration, and investigative reporting.

Qualifications:

Bachelor’s degree required, with at least two years of professional experience in investigation, auditing, social work, juvenile justice, personnel administration, law enforcement, or child support enforcement working with persons with intellectual disabilities.
Certifications such as Certified Fraud Examiner (CFE), Certified Internal Auditor (CIA), Certified Professional Coder (CPC), Certified Medicaid Integrity Program (CMIP), or Law Enforcement/Criminal Justice Certification are preferred.
Strong analytical skills and attention to detail.
Excellent communication and interpersonal skills.
Ability to analyze records, conduct interviews, and collaborate effectively with stakeholders.
Physical ability to perform office-based tasks, including extended periods of sitting, computer use, and occasional travel.

Responsibilities and Duties:

Accept information referrals and complete screening of allegations to determine investigative needs.
Identify case issues and gather evidence based on analysis of charges, complaints, or allegations.
Determine the scope, timing, and direction of investigations to ensure thorough case management.
Examine records and documents to locate links in chains of evidence or information.
Analyze member case information and billing data from medical providers.
Review eligibility, medical, and provider documents, and conduct interviews with members, provider staff, and other stakeholders.
Obtain and verify evidence through interviews, observations, and record analysis.
Collaborate with other offices and agencies to exchange information and coordinate investigative activities.
Prepare detailed reports outlining investigation findings and recommendations.
Coordinate eligibility updates with relevant OHCA and DHS units.
Identify and calculate overpaid claims, documenting findings and making referrals for recovery.
Document all case-related information, correspondence, evidence, and findings accurately.
Initiate troubleshooting activities, corrective and preventive action plans, and follow-up procedures.
Perform other duties as assigned to support program integrity.

Why Work for Galt:
Galt is a non-profit staffing agency with the mission to provide, promote, and expand employment opportunities for individuals with disabilities. We give priority in hiring individuals with disabilities including medical, physical, and psychological conditions.
Galt has and will continue to create a better workplace – one in which employers have access to skilled and motivated workers, and people of all abilities can find meaningful, sustaining work.
A devoted and friendly team that is there to help you every step of the way in advancing your career.

Job Application Process:
Galt utilizes online forms and electronic signatures throughout the hiring process. As an employer of people with disabilities, we understand assistance or accommodation may be required. Should you need accommodation, please contact us at 877-361-1277.
Note: Please allow five (5) business days to process your application.

IND-1

Quick Apply

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quality complaint investigator jobs

Program Specialist II (Investigator II)

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