Field Auditor/Investigator II

Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for underserved communities.

Best People, Best Solutions, Best Results

Job Summary:

In support of USDA SNAP Retailer investigations, collects data/information for audits/investigations concerning fraud, waste, and abuse allegations, utilizing a combination of analytical skills and attention to detail, reviewing documentation, interviewing involved parties, and communicating with various stakeholders to gather relevant information for successful resolution and closure. Identifies opportunities to proactively target fraud, waste, and abuse. Adheres to industry regulations and policies, assesses information for potential managerial follow-up. Analyzes data in order to effectively assess the validity of allegations. Provides accurate recommendations to management for resolution and closure. Documents and inputs all findings, while preparing comprehensive reports that may be used for legal or audit/investigative purposes.

Essential Functions:

• Conducts routine and impartial audits/investigations from start to closure into fraud, waste, and abuse allegations, ensuring accurate and fair assessment.
• Provides customer service by addressing inquiries and concerns, and escalates audit/investigation, as needed.
• Compiles detailed and organized records of audit/investigation findings, ensuring accuracy and compliance with legal and regulatory requirements.
• Applies functional knowledge to create and implement strategies to identify and prevent fraudulent activities.
• Conducts interviews with relevant witnesses, claimants, and other stakeholders to gather additional information and perspectives.
• Communicates with appropriate internal teams to ensure the proper processing of audits/investigations, while adhering to legal and regulatory standards.
• Communicates audit/investigation findings clearly and professionally to customers, claimants, and other stakeholders, managing expectations and providing updates.
• Assists in providing training and support to other auditors/investigators, contributing to the continuous improvement of investigative processes.

Level of Supervision Received:
Plans and arranges own work; works with manager to prioritize projects.

Education (can be substituted for experience):

Bachelor's Degree required

Experience (can be substituted for education):
2 - 4 years required; 5 - 7 years preferred

Certifications:
Private investigator license is required by customer.

Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities.

Qlarant is a drug-free workplace. All offers of employment are contingent upon successful completion of pre-employment background and drug screens.

Originally posted on Himalayas