Investigator jobs at HCSC - 41 jobs

The Special Investigations Unit (SIU) III is responsible for investigating and resolving high complexity allegations of healthcare fraud, waste and abuse (FWA) by medical professional, facilities, and members. Researches, gathers, and analyzes data to identify trends, patterns, aberrancies, and outliers in provider billing behavior. Serves as a subject matter expert for other investigators. Some travel to Massachusetts each quarter. Essential Functions: Develop, coordinate and conduct strategic fact-driven investigative projects including business process review, execution of investigative activities, and development of investigation outcome recommendations Manage the development, production, and validation of reports generated from detailed claims, eligibility, pharmacy, and clinical data and translate analytical findings into actionable items Manage strategic investigative plan and drive investigative outcome for the team Ensure quality outcomes for investigative team through auditing and oversight Prioritize, track, and report status of investigations Report identified corporate financial impact issues Use concepts and knowledge of coding guidelines to analyze complex provider claim submissions Research, comprehend and interpret various state specific Medicaid, federal Medicare, and ACA/Exchange laws, rules and guidelines Identify, research and comprehend medical standards, healthcare authoritative sources and apply knowledge to investigative approach Collaborate with data analytics team and utilize RAT STATS on Statistically Valid Random Sampling Coordinate and conduct on-site and desk audits of medical record reviews and claim audits Manage and decision claims pended for investigative purposes Maintain a working knowledge of all state and federal laws, rules, and billing guidelines for various provider specialty types Prepare and conduct in-depth complex interviews relevant to investigative plan Execute and manage provider formal corrective action plans Participate in meetings with operational departments, business partners, and regulatory partners to facilitate investigative case development Participate in meetings with Legal General Counsel to drive case legal actions, formal corrective actions, negotiations with recovery efforts, settlement agreements, and preparation of evidentiary documents for litigation Present, support, and defend investigative research to seek approval for formal corrective actions Establish and maintain relationships with Federal and State law enforcement agencies, task force members, other company SIU staff and external contacts involved in fraud investigation, detection and prevention SME in the designated market and ability to apply external intelligence to their analysis and case development Develop and present internal and external formal presentations, as needed Attend fraud, waste, and abuse training/conferences, as needed Support regulatory fraud, waste, and abuse reports to federal and state Medicare/Medicaid agencies Manage and maintain sensitive confidential investigative information Maintain compliance with state and federal laws and regulations and contracts Adhere to the CareSource Corporate Compliance Plan and the Anti-Fraud Plan Assist in Federal and State regulatory audits, as needed Perform any other job-related instructions, as requested Education and Experience: Bachelor's Degree or equivalent years of relevant work experience in Health-Related Field, Law Enforcement, or Insurance required Master's Degree (e.g., criminal justice, public health, mathematics, statistics, health economics, nursing) preferred Minimum of five (5) years of experience in healthcare fraud investigations, medical coding, pharmacy, medical research, auditing, data analytics or related field is required Competencies, Knowledge and Skills: Intermediate proficiency level in Microsoft Office to include Outlook, Word, Excel, Access, and PowerPoint Effective listening and critical thinking skills and the ability to identify gaps in logic Strong interpersonal skills, high level of professionalism, integrity and ethics in performance of all duties Excellent problem solving and decision making skills with attention to details Background in research and drawing conclusions Ability to perform intermediate data analysis and to articulate understanding of findings Ability to work under limited supervision with moderate latitude for initiative and independent judgment Ability to manage demanding investigative case load Ability to develop, prioritize and accomplish goals Self-motivated, self-directed Strong written skills with ability to compose detailed investigative reports and professional internal and external correspondences Presentation experience, beneficial Knowledge of Medicaid, Medicare, healthcare rules preferred Background in medical terminology, CPT, HCPCS, ICD codes or medical billing preferred Complex project management skills preferred Display leadership qualities Licensure and Certification: One of the following certifications is required: Accredited Healthcare Fraud Investigator (AHFI) or Certified Fraud Examiner (CFE) Certified Professional Coder (CPC) is preferred NHCAA or other fraud and abuse investigation training is preferred Working Conditions: General office environment; may be required to sit or stand for extended periods of time Occasional travel (up to 10%) to attend meetings, training, and conferences may be required Compensation Range: $72,200.00 - $115,500.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.#LI-SD1

Become a part of our caring community and help us put health first Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the Oklahoma Medicaid Team. This team of Investigators conducts investigations into allegations of fraud, waste, and abuse involving providers who submit claims to Humana's Oklahoma Medicaid line of business. As the Senior Fraud and Waste Investigator, you will serve as Humana's Program Integrity Officer, and will oversee the monitoring and enforcement of the fraud, waste, and abuse (FWA) compliance program to prevent and detect potential FWA activities pursuant to state and federal rules and regulations. Additionally, you will act as the primary point of contact for OHCA and other agencies such as the Medicaid Fraud Control Unit (MFCU) and coordinate all aspects of FWA activities in Oklahoma to increase Medicaid program transparency and accountability. You will report to the SIU Director and work closely with Humana's Oklahoma Market. Key Role Functions Carry out the provisions of the compliance plan, including FWA policies and procedures Investigate allegations of FWA and implement corrective action plans Assess records and independently refer suspected member fraud, provider fraud, and member abuse cases to the Oklahoma Health Care Authority (OHCA) and other duly authorized enforcement agencies Coordinate across all departments to encourage sensible and culturally-competent business standards Oversee internal investigations of FWA compliance issues Collaborate with the Contract Compliance Officer and Compliance Officer to create and implement tools and initiatives designed to resolve OHCA FWA contract compliance issues Respond to FWA questions, problems, and concerns from enrollees, providers, and OHCA Program Integrity Cooperate effectively with federal, state, and local investigative agencies on FWA cases to ensure best outcomes; work closely with internal and external auditors, financial investigators, and claims processing areas Assist in developing FWA education to train staff, providers, and subcontractors Attend State Agency meetings Use your skills to make an impact WORK STYLE: Remote, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. WORK HOURS: Typical business hours are Monday-Friday, 8 hours/day, 5 days/week. Required Qualifications Must be an Oklahoma resident 2+ years of healthcare fraud investigations and auditing experience Knowledge of healthcare payment methodologies Strong organizational, interpersonal, and communication skills Inquisitive nature with ability to analyze data to metrics Proficient with Microsoft Office (Word, Excel, etc.) Strong personal and professional ethics Preferred Qualifications Bachelor's degree or higher Any applicable certifications (Clinical Certifications, CPC, CCS, CFE, AHFI) Understanding of healthcare industry, claims processing and investigative process development Experience in a corporate environment and understanding of business operations Additional Information To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including: Health benefits effective day 1 Paid time off, holidays, volunteer time and jury duty pay Recognition pay 401(k) retirement savings plan with employer match Tuition assistance Scholarships for eligible dependents Parental and caregiver leave Employee charity matching program Network Resource Groups (NRGs) Career development opportunities Our Hiring Process As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called HireVue. HireVue Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you. If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Department: 60936 Wake Forest Baptist Medical Center - Lab: Autopsy: Welfare Status: Full time Benefits Eligible: Yes Hours Per Week: 40 Schedule Details/Additional Information: The hours are 8-5p M-F with periodic call weekends (remote) and some holidays. Prefer active ABMDI certification and one year experience, four year degree in related anatomy, physiology, law enforcement or biological sciences. Pay Range $30.70 - $46.05 Position Highlights: Schedule: The hours are 8-5p M-F with periodic call weekends (remote) and some holidays. Education/Experience: Bachelor's degree in Biological Sciences, Criminal Justice, Nursing, or a related field and one year experience in investigations is preferred; or an equivalent combination of education and experience. Preferential consideration will be given to applicants with grant writing experience. Licensure, Certification and/or Registration: Registered Medicolegal Death Investigator by the American Board of Medicolegal Death Investigators (ABMDI) preferred or fills the requirements to become registered within five years of hire. Obtain and maintain a valid applicable state driver's license without restrictions. Maintains a favorable background investigation. Essential Functions: Reviews death information to determine whether the death requires a medicolegal examination/autopsy. Acquires pertinent medical records/other official documents related to deaths, provides follow-up investigation for accepted cases, attends death scenes within the service's coverage area, and follows scene guidelines to insure adequate documentation of the decedent. Develops and updates policies related to investigative procedures. Performs external examinations in-house and at scenes. Aids in identification of the decedent if identity is unknown, contacts the decedent's next-of-kin or appropriate representative for death information or disposition of the body. Handles and secures evidence collected at the death scene and autopsy according to protocols. Completes autopsy forms, toxicology forms, report of investigation forms, death certificates and other pertinent paperwork related to the investigative process according to protocol. Provides phone coverage for the autopsy service and receiving and releasing bodies to funeral home representatives or other appropriate party. Attends various appropriate training programs to maintain high standards and implement new methods of investigations. Improves work skills through self-study and continuing education. Contributes to the smooth and efficient operation of the section and department. Protects self, coworkers and facility by following approved policies and procedures to prevent the spread of bloodborne and/or airborne diseases. Exhibits and promotes the professional image of laboratories in accordance with hospital, department, and professional society philosophies, goals and standards of laboratory testing. Provides maximum care in identification procedures when processing documents and labeling specimen containers and releasing bodies to funeral homes. Skills/Qualifications: Ability to travel at a moment's notice (24 hours a day) within the state of applicable state. Ability to move approximately 100 pounds and able to assist in moving heavier objects/bodies. Ability to perform assigned duties while working with decedents who died from natural/non-natural causes of death and in all phases of decomposition. Extremely pungent odors are common. Maintains confidentiality throughout process. Knowledge of Federal, State and local laws regarding deaths and human remains. Strict compliance with office policies and procedures. Operates required equipment in a safe and lawful manner for protection/safety of public, self and other employees. Ability to maintain effective working relationships with co-workers, government agencies, outside organizations, the news media, and the public. Knowledge of crime scene investigation procedures, evidence collection and transfer techniques. Ability to listen and communicate effectively especially when interacting with grieving families. Knowledge of human anatomy, physiology and medical terminology. Skill in operating digital camera. Computer skills with familiarity using electronic medical record, CoPath, Mysys, and Microsoft Office. Work Environment: Subject to irregular hours - requires working 1st shift, extended hours, on- call hours, nights, weekends and holidays. Exposure to risk of bloodborne/airborne diseases. Exposure to hazards for electrical/mechanical/power equipment. Possible exposure to odorous chemicals and specimens. Subject to injury from hot or moving parts of equipment. Moderate noise environment. Subject to many interruptions and stressful situations. Subject to cuts. Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including: Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

A bit about this role: Are you a highly analytical and experienced investigator with a passion for uncovering the truth and protecting vital healthcare resources? Our Special Investigations Unit (SIU) is looking for a skilled Investigator to join our dedicated team. In this crucial role, you'll be at the forefront of preventing, detecting, and responding to healthcare fraud, waste, and abuse (FWA), safeguarding our members and the integrity of the Medicare Fund. If you're driven by meticulous investigation, data-driven insights, and a commitment to justice, we encourage you to apply. Responsibilities and Impact will include: As an SIU Investigator, you'll be responsible for the full lifecycle of complex FWA investigations, acting as a subject matter expert and collaborating with various stakeholders. Your key responsibilities will include: Lead Complex Investigations: Plan, organize, and execute specialized investigations into allegations of healthcare fraud, waste, and abuse. This includes handling intricate cases requiring advanced investigative knowledge and skills. Data-Driven Detection: Utilize advanced data mining and analysis techniques to identify aberrancies and outliers in claims, medical records, enrollment, and other healthcare transactions. You'll independently research FWA issues and employ cutting-edge investigative resources. Expert Guidance: Serve as a subject matter expert for other SIU Investigators, providing specialized knowledge and guidance to elevate team capabilities. Policy & Strategy Development: Contribute to the development of robust policies and procedures related to FWA detection and investigation, as well as the annual SIU risk assessment and work plan. Thorough Documentation & Reporting: Conduct comprehensive FWA investigations, ensuring complete and accurate case documentation and detailed investigative reports that adhere to SIU policies and standards. External Referrals & Collaboration: Prepare comprehensive summary and detailed reports on investigative findings for referral to federal and state agencies, ensuring full compliance with regulatory requirements. You'll also actively participate in OIG Healthcare Fraud Workgroups. Stakeholder Engagement: Collaborate closely with internal stakeholders (e.g., FWA Monthly Workgroup, Market/Network, Credentialing Committee) to share updates on FWA schemes, coordinate recommendations, and facilitate fund recovery or other necessary actions. Provider Education: Conduct impactful provider education sessions as a direct response to investigation findings and audits. Liaison & Point of Contact: Serve as a key point of contact for corporate and field inquiries regarding FWA, and participate in meetings with providers, business partners, regulatory agencies, and law enforcement. Training & Development: Assist in developing and presenting engaging FWA training programs for internal and external audiences. Required skills and experience: Education: A Bachelor's Degree in Business, Criminal Justice, Healthcare, or a related field, or equivalent relevant work experience. Experience: Minimum of 3 years of dedicated experience in health insurance fraud investigation. Proven experience within Medicare and/or Medicaid programs, specifically with medical claim billing, reimbursement, audit, or provider contracting. Demonstrated experience with data analysis techniques. Experience with the Healthcare Fraud Shield platform is a significant plus. Exceptional Analytical Skills: Ability to interpret and dissect complex data sets, identifying patterns and anomalies indicative of FWA. Outstanding Communication: Excellent written and verbal communication skills are essential for clear report writing, compelling presentations, and effective stakeholder engagement. Integrity & Detail-Oriented: A strong commitment to integrity and compliance, coupled with meticulous attention to detail in all aspects of investigations. Independent & Collaborative: Proven ability to work independently, manage a diverse caseload of investigations, and thrive in a fast-paced environment, while also excelling in collaborative team settings. Strong Organizational Skills: Highly organized with the ability to manage multiple complex investigations simultaneously and effectively prioritize tasks. Desired skills and experience: Certified Fraud Examiner (CFE) Certified Professional Coder (CPC) #LI-DS1 #LI-Remote Salary range: $55,000 - $100,000 annually The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job. Our Total Rewards package includes: Employer sponsored health, dental and vision plan with low or no premium Generous paid time off $100 monthly mobile or internet stipend Stock options for all employees Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles Parental leave program 401K program And more.... *Our total rewards package is for full time employees only. Intern and Contract positions are not eligible. Healthcare equality is at the center of Devoted's mission to treat our members like family. We are committed to a diverse and vibrant workforce. At Devoted Health, we're on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States. And we've just started. So join us on this mission! Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted's Code of Conduct, our company values and the way we do business. As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. ***POSITION IS REMOTE******CANDIDATE MUST HAVE EXPERIENCE INVESTIGATING OR IDENTIFYING BEHAVIORAL HEALTH FRAUD, WASTE AND ABUSE TRENDS *** Position Purpose: Conduct comprehensive reviews of medical records and documents supporting claims for providers, suppliers, and pharmacies to include but not limited to physicians, inpatient, outpatient, ancillary, behavioral health care, laboratory, etc. Provides investigative support to the Special Investigations Unit (SIU) related to coding and billing issues and identifies potential overpayments and suspected health care fraud and abuse. Position requires the associate to verify authorization for services and written documentation of services provided against claim information, ensure the appropriateness and accuracy of diagnosis and procedure codes supporting such claims, coordinate medical necessity and appropriate level of care determinations with Medical Directors, and validate services against CMS and State-specific coverage, limitations and exclusion guidelines. Coordinate with internal and external resources in determining the appropriateness of codes found in administrative, medical, claim and financial records, develop reports of findings and recommendations, communicate complex results of audit findings in meetings and/or judicial hearings, and assist SIU investigators during interviews, discussions and negotiations with providers, suppliers, and pharmacies. Perform retrospective and prepayment reviews of medical records to identify potential fraud, waste, and abuse and inappropriate billing practices. Investigate, analyze, and identify provider billing patterns to determine payment based on medical records, claim history, billing codes, regulatory and state guidelines, and policies. Prepare summary of findings and recommend next steps for providers. Identify preventative measures and recommend changes to internal policies and procedures and/or provider practices to prevent future fraudulent and erroneous practices. Collaborate with investigators to identify abuse and fraud by utilizing clinical and coding expertise to analyze patterns in billing activities. Performs other duties as assigned Complies with all policies and standards Education/Experience: Master's Degree and 2 years of relevant experience required. 2+ years clinical experience with independent license required; 2 years of fraud, waste, and abuse experience required; experience in provider education and managed care organization preferred; coding certification preferred. License/Certification: Behavioral health license - LMHC, LCSW, LMFT, LPC, LMHP, LIMHP Pay Range: $56,200.00 - $101,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

The world's most revolutionary biopharma companies are partnering with Agilent Technologies to advance the next frontier of medicine. Agilent continues to invest in capacity and expansion of its Colorado operations. Join our team of professionals dedicated to the development and commercialization of nucleic acid therapeutics for life changing, lifesaving medicines. The Quality Control Laboratory Investigator position performs investigations for events that occur in the Quality Control laboratories, including but not limited to deviations, sample acceptance criteria not being met, analytical testing results that are potentially Out of Specification (OOS) or Out of Trend (OOT), discrepancies, unexpected results, etc., to improve the quality control testing processes by implementing corrective and preventative actions. Other duties may include writing or revising SOPs, change controls, and other technical documentation generated by Quality Control. This position description (POD) covers all levels of the Quality Control Investigator (entry, intermediate, advanced, expert, and master). ESSENTIAL DUTIES AND RESPONSIBILITIES: Lead investigation activities by gathering information from all necessary internal and external sources using investigation tools to: Perform the Root Cause Analysis (RCA) to determine if the deviation is a result of a laboratory error Evaluate the impact of the deviation on the product Determine the risk to previous products or future operations Determine what additional testing must be performed to identify root cause or to generate acceptable results and formulate testing plan. Collaborate with cross-functional teams to develop effective Corrective and Preventive Action (CAPA) plans to prevent recurrence. Author comprehensive investigation reports. Review quality and regulatory documentation and conduct interviews with internal sources to obtain an in-depth understanding of the product and process. Analyze QC laboratory data and evaluate trends to identify continuous process improvement opportunities. Consults with the Quality Assurance and Quality Control groups to resolve quality, QC Laboratory, and efficiency issues. Manage multiple deviations, CAPAs, and Change Controls as necessary to closure within established timelines and batch disposition dates. Write and/or revises technical documentation including SOPs and other documents as required. Participate with internal and external regulatory audits and inspections as required. Maintain safe, secure, and healthy manufacturing environment by adhering to organizational standards and policies and to legal regulations, alerting others regarding potential concerns. KNOWLEDGE, SKILLS, AND ABILITIES: Knowledge of Good Manufacturing Practice (GMP) guidelines as well as international regulations (i.e., International Conference on Harmonization (ICH) Q7) pertaining to the production of Active Pharmaceutical Ingredients (API) and drug products. Have the training and ability to participate in and/or lead investigations applying scientific methods and effectively present findings and solutions to customers, co-workers, or members of management. Able to identify personnel and documentation to support knowledge of equipment and processes utilized to analyze materials used in production of APIs such as, but not limited to: raw materials, in-process samples, and API/DP. Skill in communication, written and verbal. Ability to lead cross-functional teams. Ability to interface with clients as required. Knowledge of and skill in using computer software and hardware applications, including Microsoft products and the internet, are required. Computer skills, especially with Microsoft Word, Excel, Visio are preferred. Skill in managing various projects; must be able to use individual discretion in completing work assignments while assisting the group in establishing priorities, setting standards and working collectively to accomplish deadlines and objectives. Ability to read, analyze, and interpret industry-related periodicals, SOPs, and government regulations. Ability to write reports, business correspondence, and procedures. Ability to respond to common inquiries, comments or complaints from customers, co-workers, subordinates, and supervisors regarding the documents, products and processes. Actively lead or participate in the investigation of major QC laboratory investigations including providing technical assistance to Quality Assurance (QA) on the final product impact assessment and identification of root cause. Outstanding communication skills, understanding of cGMP regulations and knowledge of investigation techniques including root cause analysis (RCA) and technical writing skills are required. Works on complex problems in which analysis of situations or data requires an in-depth evaluation of various factors. Exercises judgment within broadly defined practices and policies in selecting methods, techniques and evaluation criteria for obtaining results. Qualifications Bachelor's degree in chemistry, biology, engineering or related life science field; or an equivalent combination of education and related experience. 2+ years relevant experience required Prior experience in a GMP Laboratory supporting Manufacturing in-process and release testing preferred Requires in-depth knowledge and experience in job and ability to work independently Additional Details This job has a full time weekly schedule. Applications for this job will be accepted until at least January 20, 2026 or until the job is no longer posted.The full-time equivalent pay range for this position is $93,760.00 - $146,500.00/yr plus eligibility for bonus, stock and benefits. Our pay ranges are determined by role, level, and location. Within the range, individual pay is determined by work location and additional factors, including job-related skills, experience, and relevant education or training. During the hiring process, a recruiter can share more about the specific pay range for a preferred location. Pay and benefit information by country are available at: ************************************* Agilent Technologies, Inc. is an Equal Employment Opportunity and merit-based employer that values individuals of all backgrounds at all levels. All individuals, regardless of personal characteristics, are encouraged to apply. All qualified applicants will receive consideration for employment without regard to sex, pregnancy, race, religion or religious creed, color, gender, gender identity, gender expression, national origin, ancestry, physical or mental disability, medical condition, genetic information, marital status, registered domestic partner status, age, sexual orientation, military or veteran status, protected veteran status, or any other basis protected by federal, state, local law, ordinance, or regulation and will not be discriminated against on these bases. Agilent Technologies, Inc., is committed to creating and maintaining an inclusive in the workplace where everyone is welcome, and strives to support candidates with disabilities. If you have a disability and need assistance with any part of the application or interview process or have questions about workplace accessibility, please email job_******************* or contact ***************. For more information about equal employment opportunity protections, please visit *************************************** Required: OccasionalShift: DayDuration: No End DateJob Function: Quality/Regulatory

Competitive Compensation & Benefits Package! eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Office Location: Flexible for any of our NC office locations (Must live in NC or within 40 miles of NC border) Projected Hiring Range: Depending on Experience Closing Date: Open Until Filled Primary Purpose of Position: This position will assist in the development, implementation, revision, maintenance, and promotion of the agency's fraud, waste, and abuse prevention and detection activities to ensure that the agency and the agency's network operates in a manner that complies with applicable State and Federal laws, regulations, agency policies, national accreditation, and Medicaid guidelines. This position will perform functions relating to data analysis, investigations, and auditing relating to the monitoring, detection, and resolution of healthcare fraud, waste, and abuse. Role and Responsibilities: Conduct, plan and perform independent and comprehensive audits, investigations and reviews (hereinafter referred to as investigations) into allegations of regulatory compliance violations, including fraud, waste, and abuse (FWA). Investigation includes the review of financial, consumer/clinical, provider, and/or other records, reports, and information necessary to thoroughly analyze and investigate suspected violations. Conduct clinical and non-clinical interviews, as necessary, to facilitate the investigative process. Work collaboratively with appropriate internal/external subject matter experts, agency and provider personnel, as necessary, to facilitate the investigative process. Conducts clinical chart reviews of instances of care authorized for utilization purposes, case reviews for individuals that are identified as either over or under-utilizers of services. Knowledge of documentation and clinical protocols for utilization purposes and case reviews for individual consumers in order to conduct clinical chart reviews. Clinical knowledge of managed systems of physical health services (professional and institutional), durable medical equipment, pharmacy, Mental Health, substance abuse, and Intellectual and Developmental Disabilities to also include co-occurring disorders. Knowledge of managed care practices and principles to detect fraud, waste and abuse. Clinical ability to recognize gaps in Partners Health Management service network and ability to communicate these identified gaps to appropriate parties. Serve as a Lead Investigator responsible for coordinating and leading agency investigative teams related to program integrity. Gather, evaluate, and synthesize evidence related to reported allegations to determine compliance with applicable state and federal policies, laws, and regulations. Prepare written and oral reports based on the results of assigned work that help to sustain findings and uphold disputed TNOs. Prepare timely, thorough, and accurate investigative reports; compile case file documentation; calculate overpayments; and synthesize findings in accordance with agency policies and procedures and departmental guidelines. Communicate effectively, both in writing and orally, to ensure accurate and timely completion of all assignments. Develop, implement, monitor, and maintain analytic reports to detect and prevent health care FWA. Conduct independent data mining and data analysis techniques utilizing claims data to detect abnormal claims and develop trends and patterns for potential cases. Independently prepare case documents for referral to the appropriate oversight agency and other external agencies involved in the prosecution of health care fraud. Manage cases from complaint intake through their ultimate conclusion, including supporting the case during all legal processes and appeals and the collection of final overpayments. Create, maintain, and manage cases within the case filing and tracking systems to ensure information is accurate, timely and complete. Consult with legal counsel in order to prepare testimony and other information necessary for appeals and as requested by external agencies investigating or prosecuting Medicaid fraud (as appropriate). Remain abreast of all federal and North Carolina rules and laws applicable to FWA and program integrity. Develop and conduct proactive audits, reviews and investigations of Partners' programs to facilitate the detection and resolution of FWA. Develop, coordinate, and facilitate educational training to the Provider Network and agency personnel on issues relating to the compliance program, FWA. Identify information system edits/alerts/reports in need of implementation in the claims processing system(s). Recommend and implement compliance initiatives, policies, procedures, and practices designed to promote and encourage the reporting of suspected FWA without fear of retaliation. Serve on and/or facilitate various agency committees as deemed necessary by the Program Integrity Director Use data collection instruments and protocols previously developed or adopted by the department and develop data collection instruments as needed for complex investigations. Analyze computer-generated data sets, including claims data, to identify individuals and organizations that are most likely to provide evidence to ascertain whether FWA is likely to have occurred. Develop summary reports that illustrate data analysis to a nonscientific audience. Use appropriate software and systems to complete work assignments. Consult with IT to manage data and generate needed program reports. Perform other duties as assigned. Knowledge, Skills and Abilities: Strong knowledge of state and federal laws, including those related to Medicaid FWA, and regulatory compliance are required. Knowledge of investigative methods and procedures. Knowledge of claims processing and clinical services. Excellent interpersonal and communication skills. Excellent analytical skills. Effective time management and organizational skills. Excellent conflict management skills. Proficient in Word, Excel, Outlook, and Power Point. Ability to learn and effectively manage various information systems including Partners' claims reporting and North Carolina TRACKS. Ability to develop solutions and make recommendations for necessary process improvements. Ability to interpret contractual agreements, business oriented statistics, clinical/administrative services and records. A high level of integrity and discretion is required to effectively carry out the responsibilities related to this position. Education and Experience Required: Master's degree in a Human Services field, Health Administration, health informatics/analytics, or related field, OR a Bachelor's of Science in Nursing and licensed to practice as a Registered Nurse in North Carolina by the N. C. Board of Nursing. Minimum of 3 years recent experience in the healthcare field with compliance monitoring, auditing or investigation experience. Licensed Clinical Social Worker, Licensed Clinical Mental Health Counselor, Licensed Clinical Addiction Specialist, Registered Nurse, Nurse Practitioner, Physician's Assistant, or another clinical license related to the healthcare field. Education and Experience Preferred: Five years recent experience in the healthcare field. Experience analyzing complex data, claims processing, utilization reviews, provider credentialing/monitoring, and/or fraud and abuse detection. Preferred credentials: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Coding Specialist (CCS); Certified Fraud Examiner (CFE); and/or Accredited Healthcare Fraud Investigator (AHFI) certification. Licensure/Certification Requirements: Current unrestricted LCSW, LCMHC, LPA, LMFT or LCAS licensure with the appropriate professional board of licensure in the state of North Carolina or licensed to practice as a Registered Nurse, Nurse Practitioner in North Carolina by the N. C. Board of Nursing or licensure in the State of North Carolina or licensed to practice as a Physician's Assistant by the North Carolina Medical Board. Employee is responsible for complying with respective licensure board's continuing education/ training requirements in order to maintain an active license. Must maintain licensure or certification.

At Agilent, we are driving innovation in life-changing, lifesaving medicines. Join our team in advancing the next frontier of biopharma by supporting the production of nucleic acid therapeutics. We offer an opportunity to be part of a high-performance manufacturing team dedicated to delivering perfection in our new innovative facility. Together, we're helping craft the future of medicine. The Manufacturing Operations Investigator position performs manufacturing investigations, including but not limited to deviations, environmental excursions, nonconformances, discrepancies, etc. to improve the manufacturing process by implementing corrective and preventative actions. Other duties may include writing or revising SOP's, Change Controls, and other technical documentation generated by manufacturing. Key Responsibilities Lead investigations activities by gathering information and data from all necessary internal and external sources using investigation tools to perform the following: root causes analysis (RCA) Evaluate the impact of deviation on the manufactured product and the equipment. Determine the risk to previous products or future operations. Collaborate with cross-functional teams to develop effective Corrective and Preventative Action (CAPA) plans to prevent recurrence. Author comprehensive investigation reports. Review quality and regulatory documents and conduct interviews with internal sources to obtain an in-depth understanding of the product and process. Analyze process data and evaluate trends to identify continuous process improvement opportunities. Consults with the Quality Assurance, area subject matter experts, and manufacturing groups to resolve quality, production and efficiency issues. Manage multiple Non-Conformance Records (NCR's), CAPA's, and Change Controls as necessary to closure within established timelines and batch disposition dates. Write and/or revises technical documentation including SOP's, and other documents as needed. Qualifications Bachelor's degree in a science-related field or equivalent. Knowledge of Good Manufacturing Practice (GMP) guidelines as well as international regulations (i.e., International Conference on Harmonization (ICH) Q& pertaining to the production of Active Pharmaceutical Ingredients (API) and drug products. Possess the training and ability to lead investigations by applying scientific methods and effectively present findings and solutions to customers, co-workers, or members of management. Able to identify personnel and documentation to support knowledge of equipment and processes utilized to manufacture oligonucleotide API's such as, but not limited to, Solid Phase Oligonucleotide Synthesis, Deprotection, Chromatographic Purification (AX, RP, HIC, etc.), Ultrafiltration, Concentration, Annealing and Lyophilization. Skilled utilizing Microsoft products (Word, Excel and Visio preferred). Skilled in managing various projects; must be able to use individual discretion in completing work assignments while assisting the group in establishing priorities, setting standards and working collectively to accomplish deadlines and objectives. 3+ years related experience and/or training working in a GMP Production Environment applying Root Cause Analysis techniques is required. Bachelor's degree in a science-related field or equivalent experience. 1+ years of meaningful experience, ideally in a GMP manufacturing environment. Strong understanding of GMP guidelines and international regulations for API and drug production. Experience with root cause analysis, technical writing, and SOP development. Proficient in Microsoft Word and other standard software applications. Excellent communication and leadership skills, with the ability to run cross-functional teams and sophisticated projects. Additional Details This job has a full time weekly schedule. Applications for this job will be accepted until at least January 22, 2026 or until the job is no longer posted.The full-time equivalent pay range for this position is $74,560.00 - $116,500.00/yr plus eligibility for bonus, stock and benefits. Our pay ranges are determined by role, level, and location. Within the range, individual pay is determined by work location and additional factors, including job-related skills, experience, and relevant education or training. During the hiring process, a recruiter can share more about the specific pay range for a preferred location. Pay and benefit information by country are available at: ************************************* Agilent Technologies, Inc. is an Equal Employment Opportunity and merit-based employer that values individuals of all backgrounds at all levels. All individuals, regardless of personal characteristics, are encouraged to apply. All qualified applicants will receive consideration for employment without regard to sex, pregnancy, race, religion or religious creed, color, gender, gender identity, gender expression, national origin, ancestry, physical or mental disability, medical condition, genetic information, marital status, registered domestic partner status, age, sexual orientation, military or veteran status, protected veteran status, or any other basis protected by federal, state, local law, ordinance, or regulation and will not be discriminated against on these bases. Agilent Technologies, Inc., is committed to creating and maintaining an inclusive in the workplace where everyone is welcome, and strives to support candidates with disabilities. If you have a disability and need assistance with any part of the application or interview process or have questions about workplace accessibility, please email job_******************* or contact ***************. For more information about equal employment opportunity protections, please visit *************************************** Required: NoShift: DayDuration: No End DateJob Function: Quality/Regulatory

QUALIFICATIONS Education: Advanced practice degree NP Experience: Two (2) year of experience as an Advanced Practitioner, two (2) year of experience starting and performing phlebotomy, IVs, subcutaneous injections, collecting vital signs, ECG, and urine collection. One (1) year of recent clinical research experience preferred. Computer Skills: Excellent computer Skills, including Microsoft Outlook, Word, Excel, and PowerPoint. Certificates & Licenses: current unrestricted licensure to practice as an Advanced Practitioner (NP or PA) in the state to which the candidate is assigned. Current BLS certification required. CITI, GCP, and IATA preferred. Other Knowledge, Skills, and Abilities: Excellent verbal and written communication. Experience collecting, processing, and shipping lab specimen(s). Use of considerable judgment/critical thinking in application of procedures, nursing assessment techniques, practices, and policies to work problems, organization, and administration of research or outpatient clinic. Working knowledge of federal, state, and local laws and regulations governing research. Ability to provide patient-centric focus. Adaptability/flexibility to react positively to changes in work environment. Initiative to improve productivity and quality of work. Ability to plan and organize work in logical and efficient manner. Ability to manage time delicate projects to meet deadlines. Strong attention to detail. Excellent ability to establish and maintain effective working relationships. Prolonged periods of sitting at a desk and working on a computer. Prolonged periods of standing, bending, and reaching. Must be able to lift up to 50 pounds at times. Have the ability to travel, a valid state driver license and able to drive a car, proof of adequate automobile insurance coverage for the state of residence. Ability to travel regionally by car or nationally by plane. Possess cellular phone, reliable transportation, and access to the internet. ESSENTIAL FUNCTIONS/AREAS OF ACCOUNTABILITY Serves as a leader to the study team to execute clinical trials by mentoring and training staff in the conduct of clinical trials, protocol requirements, communication, and trial management skills. Screens and confirm subject eligibility in assigned clinical trials in accordance with the Health Insurance Portability and Accountability Act (HIPAA) standards. Performs pediatric, adult, and geriatric participant visits, including but not limited to medical history collection, medication reconciliation, physical exam, and health education. Conduct and manage clinical trials in accordance with the study protocol, GCP, ICH Guidelines and SOPs. Implement and coordinate assigned clinical trials including start up, vendor management, subject recruitment, source development review, scheduling subjects, protocol training, collection of regulatory documents, conducting visits, ensuring data is entered in a timely manner and all queries are resolved, managing, and reporting adverse events, serious adverse events, and deviations, implementing new protocol amendments, providing all close out reports. As delegated, administers medications, investigational products, and vaccinations. As delegated, assess serious and adverse events as related to investigational product. Incorporate understanding of product development lifecycle and significance of protocol design including critical data points when planning for each assigned protocol Perform clinical duties (e.g., Drug preparation and administration, phlebotomy, ECG, lab processing) within scope. Assists in coordinating research subject's consent and entry into appropriate research studies ensuring that all inclusion and exclusion criteria are met. Assist with electronic data entry. Reviews new protocols and other materials provided by study sponsors and gives input to the Principal Investigators (PIs), site leadership, and virtual Clinical Research Coordinators, as applicable, regarding nursing and research issues in order to resolve financial and clinical feasibility. Helps ensure that all study related activities are complete including returning supplies, returning unused stock of study drug/devices, and confirming that all queries are complete. Maintains current knowledge of departmental functions through reading literature, attending workshops, seminars, and conferences, and by participating in professional organizations. Assists in conducting audits of research studies to check the accuracy, integrity, and consistency of the research studies. Works collaboratively with physicians, nurses, clinical research specialists, leaders, family members, key care givers and any ancillary medical personnel as appropriate. Follows ALCOA +C good documentation practices. Maintains compliance with OSHA, HIPPA and State Board of Nursing. Supports Community Engagement team with building the community and developing relationships within that community to assist with the recruitment of participants, such as attending community events, speaking with physicians / healthcare professionals and people across diverse cultures and backgrounds. Evaluate potential subjects for participation in clinical trials including phone and in person prescreens. Create and execute recruitment strategies in conjunction with patient recruitment staff. Performs other duties as assigned including but limited to home visits, recruitment, and community engagement activities, which may occur after hours and/or on weekends. Regular and reliable attendance with the ability to work after hours/weekends as needed as well as rotating on-call shifts that may include weeknights, weekends, and holidays. Any other duties needed to help drive to our vision, fulfill our mission, and abide by EmVenio's values.

McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a SIU Coder, to join in leading the organization forward. MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA). MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. Learn more about McLaren Health Plan at ********************************* Position Overview: The Special Investigations Unit (SIU) Coder supports lines of business from McLaren Health Plan, Inc., McLaren Health Plan Community, and McLaren Health Advantage (McLaren) and is responsible for performing medical claims and records reviews to assist in investigations, ensuring compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The SIU Coder works in collaboration with a team of SIU Auditors to review records and claims as part of the ongoing audits of the SIU department. The SIU Coder serves as the subject matter expert for all coding activities and collaborates with other departments within McLaren on payment integrity and provider education. This position is fully remote. Qualifications: Required: * Associate's Degree in Health Information Management, Healthcare Business Services, or equivalent program with emphasis in coding or High School diploma with two (2) years of related experience. * Certified Medical Coder (CPC, RHIT, or RHIA). * Two (2) years of hands-on experience in ICD-10-CM and AMA diagnostic coding (with a preference for program integrity coding) and ICD-10 and AMA coding guidelines with the ability to interpret complex medical documentation accurately. * Two (2) years of coding experience on multiple specialties. Preferred: * Five (5) years coding and/or coding and billing experience. * Two (2) years' experience assisting with SIU audits. * Managed Care experience. Additional Information * Schedule: Full-time * Requisition ID: 26000572 * Daily Work Times: 8:30 am - 5:00 pm * Hours Per Pay Period: 80 * On Call: No * Weekends: No

Conducts investigations to resolve child nutrition program complaints: * Independently answers complex and situational correspondence regarding compliance investigations. * Assists with the office's non-compliance investigative referrals related to child nutrition program compliance. * Assists with the initial investigation/evaluation of non-compliance investigative documents to determine child nutrition program non-compliance. * Answers general telephone inquiries. * Directs callers to appropriate staff & when appropriate responds to routine inquiries about the child nutrition program compliance investigation/process. * Helps monitor the Serious Deficiency process for sponsors, ensuring the Office is in compliance to process dates and deadlines. Gathers preliminary data to supplement investigations * Research & studies records, reports & documents. * Verifies information given by parties. * Interviews parties or witnesses in-office, email or by telephone. * Conducts correspondence to request & verify information. * Gathers documentation or evidence. * Verifies information provided by complainant and school districts. * Assists with the office's general email account to assist individuals with questions about child nutrition compliance. Complies and evaluates information gathered and prepares written reports of findings. Drafts routine letters & prepares reports documenting investigation findings. * Maintains accurate documentation of completed tasks (in electronic form) according to office guidelines. * Prepares spreadsheets to track records & evidence. * Assists the program administrator with gathering & verifying compliance data for office and legal review. * Maintains confidentiality of all records & information in accordance with Ohio law. Performs other duties (e.g., maintains electronic and hard copy files; 30 mos. trg. or 30 mos. investigative exp. with experience corresponding to type of complaints & alleged violations appearing in job posting/approved position description; valid driver's license. * Or Completion of associate core program in law enforcement, criminal justice or in academic field commensurate with program area to be assigned per approved Position Description on file; 12 mos. exp. conducting investigations &/or inspections; valid driver's license. * Or 30 mos. trg. or 30 mos. exp. as Investigator Assistant, 26210 with experience corresponding to type of complaints & alleged violations appearing in job posting/approved position description; valid driver's license. * Or equivalent of Minimum Class Qualifications for Employment noted above. Job Skills: Investigation

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. **Please note: this is a remote position, but candidates located in Texas are highly preferred.** **Position Purpose:** Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse. + Conduct investigations of potential waste, abuse, and fraud + Document activity on each case and refer issues to the appropriate party + Perform data mining and analysis to detect aberrancies and outliers in claims + Develop new queries and reports to detect potential waste, abuse, and fraud + Provide case updates on progress of investigations and coordinate with Health Plans on recommendations and further actions and/or resolutions + Assist with complex allegations of healthcare fraud + Prepare summary and/or detailed reports on investigative findings for referral to Federal and State agencies + Complete various special projects and audits + Performs other duties as assigned + Complies with all policies and standards **Education/Experience:** Bachelor's Degree in Business, Criminal Justice, Healthcare, related field or equivalent experience. 1+ years of medical claim investigation, medical claim audit, medical claim analysis, or fraud investigation experience. Pay Range: $56,200.00 - $101,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

What You'll Do: BHIW is seeking an experienced Epidemiologist who will independently design, initiate, and conduct epidemiological projects and investigations focused on injury prevention (unintentional and intentional injuries). Additional duties may include: * Serve as lead worker providing direction, training, and technical guidance to lower-level epidemiology staff and public health personnel. * Conduct analytic research and data analysis using multiple data sources (e.g., Vital Statistics, OH-VDRS, syndromic surveillance, hospital discharge data). * Develop and implement research tools, methodologies, and sampling techniques; design surveys and assessment instruments. * Perform computer-based statistical analyses using SAS and other software; produce comprehensive injury reports, dashboards, and fact sheets. * Monitor injury trends, predict morbidity and mortality changes, and disseminate Epi Alerts to state partners. * Coordinate literature reviews, respond to technical inquiries from media and public health organizations, and present findings at professional meetings. * Assist with grant writing, policy development, and administrative duties related to injury surveillance. * Fulfill CDC grant requirements for data deliverables and ensure quality control for data management. Normal working hours are Monday through Friday, 8:00am to 5:00pm. Unless required by legislation, the selected candidate will begin at Pay Grade 33, Step 1 of the OCSEA Pay Range Schedule ($33.52 per hour), with an opportunity for pay increase after six months ($35.15) of satisfactory performance and then a yearly raise thereafter. Position Qualifications Completion of graduate core program in public health or preventive medicine; 3 courses or 9 mos. exp. in use of statistical computer software packages; 6 mos. exp. as epidemiology investigator with local or federal health agency; must be able to provide own transportation. OR 6 mos. exp. as Epidemiology Investigator 2, 65762; must be able to provide own transportation. OR Equivalent of Minimum Class Qualifications For Employment noted above. Applications of those who meet the minimum qualifications will be further evaluated against the following criteria: * Graduate or advanced degree in public health or preventive medicine * Course work in epidemiology, biostatistics, health statistics, data analysis, mathematics * Experience in collecting, analyzing and interpreting statistical analysis of health, particularly injury-related data * Experience managing and analyzing large datasets * Experience in developing public health surveillance reports and giving oral presentations * Experience in designing and conducting studies/projects/surveys to investigate health and injury issues * Experience in database and analytic software packages (e.g., Access, Excel, ArcGIS, STATA, SAS, R, SPSS) * Experience in word processing and presentation software (e.g., Word, PowerPoint) * Experience with or training in the creation of data visualizations/dashboards using visualization software All eligible applications shall be reviewed considering the following criteria: qualifications, experience, education, and active disciplinary record. Job Skills: Public Health Technical Skills: Data Analytics, Data Modeling, Public Health Professional Skills: Analyzation, Interpreting Data, Written Communication Educational Transcript Requirements: Official educational transcripts are required for all post-high school educational accomplishments, coursework or degrees claimed on the application. Applicants will be required to submit an official transcript prior to receiving a formal offer of employment. Failure to provide transcripts within five (5) working days of being requested will cause the applicant to be eliminated from further consideration. Please note that a transcript is considered "official" only if it is an original copy from the educational institution and includes an institutional watermark, ink stamp or embossed stamp. Transcripts printed from the institution's website will not be accepted. ODH reserves the right to assess the academic credibility of an educational entity's award of a putative degree.

What You'll Do: BHIW is seeking an experienced Epidemiologist who will independently design, initiate, and conduct epidemiological projects focused on suicide and self-harm injury prevention at the Ohio-specific level. Additional duties may include: * Serve as lead worker providing direction, training, and technical guidance to lower-level epidemiology staff. * Coordinate data analysis of confidential records; ensure quality control for data management and statistical analysis. * Develop research tools and methodologies, including surveys, sampling techniques, and literature reviews. * Analyze data from multiple sources (e.g., OH-VDRS, syndromic surveillance, hospital discharge, Vital Statistics) and produce reports, dashboards, fact sheets, and briefs. * Create and maintain suicide-related data products and update content for injury prevention websites. * Assist with coroner data collection improvements and CDC grant deliverables. * Operate statistical software (e.g., SAS, R, SPSS) to perform advanced analyses and generate comprehensive reports. * Respond to technical inquiries and prepare presentations for public health professionals and general audiences. * Collaborate with state agencies (e.g., Ohio MHAS, RecoveryOhio), local health departments, and researchers to improve suicide surveillance. * Assist with grant writing, policy development, and administrative duties related to suicide surveillance. * Represent suicide surveillance efforts at meetings, conferences, and trainings. Normal working hours are Monday through Friday, 8:00am to 5:00pm. Unless required by legislation, the selected candidate will begin at Pay Grade 33, Step 1 of the OCSEA Pay Range Schedule ($33.52 per hour), with an opportunity for pay increase after six months ($35.15) of satisfactory performance and then a yearly raise thereafter. Position Qualifications Completion of graduate core program in public health or preventive medicine; 3 courses or 9 mos. exp. in use of statistical computer software packages; 6 mos. exp. as epidemiology investigator with local or federal health agency; must be able to provide own transportation. OR 6 mos. exp. as Epidemiology Investigator 2, 65762; must be able to provide own transportation. OR Equivalent of Minimum Class Qualifications For Employment noted above. Applications of those who meet the minimum qualifications will be further evaluated against the following criteria: * Graduate or advanced degree in public health or preventive medicine * Course work in epidemiology, biostatistics, health statistics, data analysis, mathematics * Experience in collecting, analyzing and interpreting statistical analysis of health (injury) related data * Experience managing and analyzing large datasets * Experience in developing public health surveillance reports and giving oral presentations * Experience in designing and conducting studies/projects/surveys to investigate health and injury issues * Experience in database and analytic software packages (e.g., Access, Excel, ArcView- GIS, STATA, SAS, SPSS) * Experience in word processing and presentation software (e.g., Word, PowerPoint) * Experience with or training in the creation of data visualizations/dashboard using Tableau * Experience in suicide data collection/analysis or prevention All eligible applications shall be reviewed considering the following criteria: qualifications, experience, education, and active disciplinary record. Job Skills: Public Health Technical Skills: Data Analytics, Data Modeling, Public Health Professional Skills: Analyzation, Interpreting Data, Written Communication Educational Transcript Requirements: Official educational transcripts are required for all post-high school educational accomplishments, coursework or degrees claimed on the application. Applicants will be required to submit an official transcript prior to receiving a formal offer of employment. Failure to provide transcripts within five (5) working days of being requested will cause the applicant to be eliminated from further consideration. Please note that a transcript is considered "official" only if it is an original copy from the educational institution and includes an institutional watermark, ink stamp or embossed stamp. Transcripts printed from the institution's website will not be accepted. ODH reserves the right to assess the academic credibility of an educational entity's award of a putative degree.

Legend Biotech is a global biotechnology company dedicated to treating, and one day curing, life-threatening diseases. Headquartered in Somerset, New Jersey, we are developing advanced cell therapies across a diverse array of technology platforms, including autologous and allogenic chimeric antigen receptor T-cell, T-cell receptor (TCR-T), and natural killer (NK) cell-based immunotherapy. From our three R&D sites around the world, we apply these innovative technologies to pursue the discovery of safe, efficacious and cutting-edge therapeutics for patients worldwide. Legend Biotech entered into a global collaboration agreement with Janssen, one of the pharmaceutical companies of Johnson & Johnson, to jointly develop and commercialize ciltacabtagene autolecuel (cilta-cel). Our strategic partnership is designed to combine the strengths and expertise of both companies to advance the promise of an immunotherapy in the treatment of multiple myeloma. Legend Biotech is seeking an Investigator I/II as part of the Technical Operations team based in Raritan, NJ. Role Overview The CAR-T Investigator will be part of the Technical Operation team and will be responsible to provide specialist knowledge and expertise of cell and gene therapy processes and/or process technologies. They will also oversee processes and standards to maintain and improve existing and to implement new innovative manufacturing technologies. Key Responsibilities Lead manufacturing and cross functional investigations from end to end. Ensure thorough root cause analysis, impact assessment, and CAPA/EC determination. Work cross functionally with SME's and Quality to ensure robustness of investigations, as well as accuracy and ensuring compliance. Support and manage change controls and maintain permanent inspection readiness and actively support regulatory inspections. Ensure investigations are processing timely according to site specified requirements. Provide technical expertise in the Technical Operations group, own the process knowledge of the cell and gene therapy manufacturing process technology and maintain oversight on process capability to ensure processes are robust and continuously improving. Ensure seamless flow of knowledge and information across functions, and with other sites when applicable. Provide technical/scientific process support. Provide support and technical expertise to the Manufacturing team in support of ongoing technical transfer and manufacturing operations. Support the implementation of manufacturing and process automation strategies through cell therapy manufacturing process design qualification, vendor evaluation, and enterprise system interface engineering support for GMP manufacturing of engineered autologous T cell therapy products. Write and/or review user requirements, functional requirement specifications, qualification protocols, enterprise or system interface, process development reports, and provide technical assessments, rationales, and approval for engineering and process changes to meet regulatory requirements. Work closely with cross-functional teams to design and implement cell therapy processes, manage equipment qualification strategy, and support process validation activities for cell therapy platforms. Work cross-functionally across Technical Operations and interface with external vendors to drive the design and implementation of automation platforms for cell therapy development and manufacturing. Primary role is to support deviation investigation writing. Requirements BS/BA required in technical discipline: Engineering, science or similar field. A minimum of five (5) years experience within a cGMP environment in the biotech/biopharma industry and Cell/Gene Therapy cGMP manufacturing experience preferred. Support writing of SOPs for Manufacturing and Quality Risk Assessments for existing and new/changed processes. Ability to work independently and successfully, prioritize and manage multiple tasks simultaneously, integrate cross-functional issues and balance competing priorities effectively. Must be able to manage shifting priorities to meet critical deadlines in a fast paced and dynamic, growing environment. Support Manufacturing team to troubleshoot and resolve complex scientific/technical problems. Provide technical expertise to drive the implementation of process improvements that would provide reduction in COGs, increase throughput, capacity and quality compliance. Provide technical expertise in automation projects from user requirements, design evaluation, specification review through to testing and implementation in a GMP manufacturing environment. Work cross-functionally across Technical Operations and interface with external vendors to drive the design and implementation of automation platforms for cell therapy development and manufacturing. Perform technical feasibility studies related to process improvement and implementation of new manufacturing technologies. Provide SME expertise to perform process characterization of cell therapy automation technologies, including process development, FATs, SATs, and IQ/OQ/PQ testing. Ensure successful manufacturing process comparability and process validation runs by assessing risk, establishing preventative measures, investigating, and troubleshooting equipment and process issues prior to implementation into manufacturing. An ability to build strong partnerships and effectively integrate with external collaborators to drive projects/programs forward in a matrixed environment. Build strong partnerships with Manufacturing, Engineering and Quality to ensure seamless execution of daily production schedules. #Li-RN1 #Li-Onsite The base pay range below is what Legend Biotech USA Inc. reasonably expects to offer at the time of posting. Actual compensation may vary based on experience, skills, qualifications, and geographic location. The company reserves the right to modify this range as needed and in accordance with applicable laws. Performance-based bonus and/or equity is available to employees in eligible roles. The anticipated base pay range is:$81,273-$106,669 USD Benefits Benefits include medical, dental, and vision insurance as well as a 401(k) retirement plan with a company match that vests fully on day one. We offer eight (8) weeks of paid parental leave after just three (3) months of employment, and a paid time off policy that includes vacation time, personal time, sick time, floating holidays, and eleven (11) company holidays. Additional benefits include flexible spending and health savings accounts, life and AD&D insurance, short- and long-term disability coverage, legal assistance, and supplemental plans such as pet, critical illness, accident, and hospital indemnity insurance. We also provide commuter benefits, family planning and care resources, well-being initiatives, and peer-to-peer recognition programs; demonstrating our ongoing commitment to building a culture where our people feel empowered, supported, and inspired to do their best work. Please note: These benefits are offered exclusively to permanent full-time employees. Contract employees are not eligible for benefits through Legend Biotech. EEO Statement It is the policy of Legend Biotech to provide equal employment opportunities without regard to actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth, related medical conditions and lactation), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, disability, genetic information, or any other protected characteristic under applicable federal, state or local laws or ordinances. Employment is at-will and may be terminated at any time with or without cause or notice by the employee or the company. Legend may adjust base salary or other discretionary compensation at any time based on individual, team, performance, or market conditions. For information related to our privacy policy, please review: Legend Biotech Privacy Policy.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. *****POSITION IS REMOTE***** *****CANDIDATE MUST HAVE EXPERIENCE INVESTIGATING OR IDENTIFYING BEHAVIORAL HEALTH FRAUD, WASTE AND ABUSE TRENDS ***** **Position Purpose:** Conduct comprehensive reviews of medical records and documents supporting claims for providers, suppliers, and pharmacies to include but not limited to physicians, inpatient, outpatient, ancillary, behavioral health care, laboratory, etc. Provides investigative support to the Special Investigations Unit (SIU) related to coding and billing issues and identifies potential overpayments and suspected health care fraud and abuse. Position requires the associate to verify authorization for services and written documentation of services provided against claim information, ensure the appropriateness and accuracy of diagnosis and procedure codes supporting such claims, coordinate medical necessity and appropriate level of care determinations with Medical Directors, and validate services against CMS and State-specific coverage, limitations and exclusion guidelines. Coordinate with internal and external resources in determining the appropriateness of codes found in administrative, medical, claim and financial records, develop reports of findings and recommendations, communicate complex results of audit findings in meetings and/or judicial hearings, and assist SIU investigators during interviews, discussions and negotiations with providers, suppliers, and pharmacies. + Perform retrospective and prepayment reviews of medical records to identify potential fraud, waste, and abuse and inappropriate billing practices. + Investigate, analyze, and identify provider billing patterns to determine payment based on medical records, claim history, billing codes, regulatory and state guidelines, and policies. + Prepare summary of findings and recommend next steps for providers. + Identify preventative measures and recommend changes to internal policies and procedures and/or provider practices to prevent future fraudulent and erroneous practices. + Collaborate with investigators to identify abuse and fraud by utilizing clinical and coding expertise to analyze patterns in billing activities. + Performs other duties as assigned + Complies with all policies and standards **Education/Experience:** Master's Degree and 2 years of relevant experience required. 2+ years clinical experience with independent license required; 2 years of fraud, waste, and abuse experience required; experience in provider education and managed care organization preferred; coding certification preferred. **License/Certification:** Behavioral health license - LMHC, LCSW, LMFT, LPC, LMHP, LIMHP Pay Range: $56,200.00 - $101,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Remote Office , Santa Fe, New Mexico 87501, United States of America Compensation Pay Range: Minimum Offer $: 51209.6 is up to $: 78166.4 Now hiring a Investigator III-ABQ Summary: Build your Career. Make a Difference. Presbyterian is hiring a skilled Fraud Investigator to join our team. Type of Opportunity: Full time Job Exempt: Yes Job is based : Remote Workers New Mexico Work Shift: Days (United States of America) Responsibilities: The SIU Investigator III supports Program Integrity efforts at Presbyterian Health Plan by conducting complex investigations into suspected healthcare fraud, waste, or abuse across providers, pharmacies, employees, members, and brokers. Responsibilities include reviewing medical records, identifying improper billing or coding practices, interviewing involved parties, coordinating overpayment recovery, and educating on documentation standards. Ideal candidates bring strong experience in healthcare claims investigations, especially within Medicaid, Medicare, Marketplace, and commercial health plans. Some key responsibilities include: Conduct complex investigations involving providers, pharmacies, employees, members, and brokers. Perform detailed medical coding audits and analyze referral-based fraud, waste, or abuse cases. Prepare accurate reports, legal documents, and referrals for government agencies. Maintain thorough case documentation in the SIU case management system. Communicate effectively with government agencies, providers, and internal teams. Use multiple systems to analyze claims and detect fraudulent patterns. Research coding rules and regulations to support investigations. Resolve conflicts from audit findings and manage post-audit case reviews. Collaborate on investigations and recommend process improvements. Conduct audits, recover overpayments, and educate providers on billing practices. Qualifications: Bachelors degree, plus three years related healthcare experience required. Six years of additional experience can be substituted in lieu of degree. Certified Professional Coder (CPC) through the American Academy of Professional Coders (AAPC) or equivalent required Preferred Qualifications Certified Professional Medical Auditor (CPMA) through the AAPC Certified Fraud Examiner (CFE) or Accredited Health Care Fraud Investigator (AHFI) All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits. Wellness Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more. Why work at Presbyterian? As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. About Presbyterian Healthcare Services Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses. Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses. We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services

PharmaCann, Inc. owns and operates best-in-class production facilities and retail dispensaries for cannabis-based products. We currently operate in the States of Illinois, New York, Massachusetts, Ohio, Pennsylvania, Maryland, Colorado and Michigan as a medical and/or adult use cannabis provider to patients and customers. We are looking for energetic, results-driven individuals to join our rapidly growing team and industry. The Senior Asset Protection Investigator will be responsible for protecting the profitability of the company through detection, identification, investigation, and reduction of shrink and compliance exposures, throughout the entire vertical structure of PharmaCann. They will also be responsible for ensuring all of the company's properties are safe and secure, by assisting the Regional Asset Protection Manager with implementation and administration of policies and programs which include establishing and maintaining operational procedures, training requirements, internal controls, and the monitoring/reporting of processes in order to comply with all applicable local, state and federal laws, rules and regulations. The salary for the role is up to $65,000 Essential Functions / Responsibilities Monitoring & reviewing of electronic surveillance (Access Control & CCTV) as well as security alarm systems (Intrusion/Fire). Providing direction to security associates when they assist with ongoing investigations. Inspect company properties for Security & Asset Protection concerns and then assist with correcting and further securing. Develops partnerships & collaborates with 3rd party Contract Security Services, Federal, State and Local Law Enforcement agencies, which improves prosecution, restitution opportunities, and ensures the protection of company assets/employees. Assist in coordination of physical security programs (alarms, CCTV, access control). Support operations of the SOC when needed, ensuring necessary coverage is in place, and filing in when there are shortages in staffing. Assisting with the development of training for Emergency Preparedness and Response. Support all functional areas of the business when needed, during critical emergencies. Assists with facilitating the objectives of the Security team, by providing answers to questions, as well as providing the team with the tools and resources they need to perform their tasks. Performing Asset Protection related audits, with a focus on access control, camera systems and alarm sy Investigate inventory compliance and accuracy at Dispensaries and Cultivation facilities. Observing and inspecting the receipt and delivery of product at Dispensaries and Cultivation sites. Stay current with all laws, rules, and regulations as they pertain to Asset Protection and Security. Program intrusion detection systems and ensure accuracy. Assisting with the development of new SOPs and programs for the various departments within the company. Utilize all available data & incident reporting tools to identify trends, hotspots, and other potential opportunities that require further investigation. Conduct internal investigations and interviews relevant to inventory/cash variances, theft, fraud, dishonest/unethical behavior, damage to the business/property, operational opportunities and violations of policy that adversely affect sales, compliance, loss, or brand integrity. Conduct investigative interviews either in-person or via telephone, Zoom, Teams, or similar platforms. Maintain thorough and accurate documentation of investigative findings to present operational/compliance failures & dishonest/unethical activity to Human Resources, Operations Executives, Legal, and/or Law Enforcement. Assist with the development of exception reporting that will help identify potential fraud and vulnerabilities that exist within the company's ecommerce format. Investigate fraud relating to Online Orders, loyalty programs and Identity Theft. Assist with the development and rollout of a shrink program for the company. Investigate operational opportunities that may be causing shrink within the company. Assist with identifying and responding to scam/social engineering attempts. Partner with IT on developing new ways to protect against scam/social engineering attempts. Partner with on-site leadership and Human Resources to identify/resolve rule infractions or violations committed by PharmaCann employees and partnering vendors. Projects a positive image of the organization to employees, customers, industry, and community. Embodies the culture, values, and tenets of PharmaCann and full support of our purpose, goal, and key objectives. Competencies and Qualifications Minimum 21 years of age. Pass a comprehensive multi-state background check, including criminal history & obtain/maintain state agent requirements. Valid driver's license and ability to successfully pass a Motor Vehicle Record background check. Minimum of 3-5 years of experience in Asset Protection/Loss Prevention, with at least 1-2 years of investigations experience preferred. Experience in using CCTV (experience with multiple CCTV configurations and vendors, is highly desired). Analytical capabilities with a proven aptitude for learning new applications. Ability and willingness to travel overnight for business purposes. Proven ability to perform independently with minimal supervision. Proficient knowledge of exception-based reporting, Microsoft Office (Excel, Word, PowerPoint, and Power BI). The successful candidate must be comfortable working in a fast-paced, rapidly changing environment, capable of handling multiple tasks and possess excellent organizational, communication and analytical skills. Demonstrated safety, security, risk management, and client service capabilities. Ability to deliver clear, concise, accurate and effective communication (verbal and written) proactively. Excellent problem-solving ability and ability to make sound and reasonable decisions through careful evaluation and understanding of the impact of those decisions. High School degree or equivalent required. 2-year college degree or related college coursework in criminal justice, risk management, or business is preferred. Wicklander-Zulawski certification preferred. Working Conditions Able to use a computer for extended periods of time. Able to move about a typical retail, office, and manufacturing/warehouse environment. Able to perform general office managerial and administrative activities. Able to visually observe, speak, and hear. Able to stand for long periods of time, walk constantly, use hands or feet, reach with hands and arms, and may be required to lift up to 50 pounds. Regular and on-time attendance. Hours can exceed 40 hours per week, and will require weekends, nights, holidays, and open work availability. Occasional travel by conventional means to other locations as required is possible. Schedule will consist primarily of peak hours for location, but will require supporting overnight or late night shifts, when needed. This position may be required to work outdoors and/or during inclement weather. Notice: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required and are not intended to be an exhaustive list of all duties, responsibilities or qualifications associated with this job. We are an Equal Employment Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race color, religion, sex, national origin, sexual orientation, gender identity, disability, protected veteran status or any other status protected by applicable law.

Service Monitoring & Enforcement Department (SMED) Facility and Operations Field Division (FOFD) Hourly Rate: $33.52 About The Service Monitoring & Enforcement Department: The Service Monitoring and Enforcement Department's (SMED) mission is to enforce consumer safeguards, to resolve consumer complaints and to ensure Ohio utility consumers receive safe and reliable services. SMED is organized into three divisions. Facility Operations Field Division (FOFD) Facility Operations Field Division (FOFD) staff regularly inspects utility facilities and reviews plant operating practices to ensure regulated utility service providers deliver safe, reliable and quality service. Field investigators from the division's electric, telephone, water/wastewater and gas pipeline safety sections perform on-site inspections and audit company records to ensure utilities observe regulatory requirements. FOFD staff also participates in rate case proceedings and recommends changes in company policies and practices to improve utility service. FOFD staff also acts as the agency lead for the damage prevention complaint reporting and tracking process; assisting with the maintenance of the damage prevention enforcement database; and answering internal and public inquiries. What You'll Do: The Gas Pipeline Safety team at the PUCO is responsible for enforcing federal and state pipeline safety regulations. We work in partnership with the federal Pipeline and Hazardous Materials Safety Administration (PHMSA). In this position as a Gas Pipeline Safety Compliance Investigator, you will be a field-based employee responsible for scheduling, coordinating, and conducting independent field audits and inspections with gas utilities. Inspections include: * Reviews of company plans and procedures * Reviews of company construction, operations, and maintenance records * Field observations of gas company employees and contractors * Field inspections of company pipeline facilities. You will also be assigned to investigate natural gas related incidents and complaints. The position will involve learning and applying federal and state pipeline safety regulations to various company records and facilities to determine whether the company is complying with the regulations. Some inspections are performed as part of a team, but most inspections are performed independently. This position will be based in North Central Ohio and most assignments will be in that part of the state but occasional assignments requiring overnight stays in other parts of the state are possible. Travel to Columbus will also be required throughout the year for meetings at the PUCO headquarters in downtown Columbus. The position will also require the successful completion of several training courses at PHMSA's training facility in Oklahoma City, OK during the first 3 years in the position. A state vehicle will be assigned for work related travel within the state. The selected candidate must reside in or relocate to Marion, Morrow, Crawford, or Richland County areas. Please make sure the duty section of your work history clearly demonstrates 5 years of natural gas related experience to meet minimum qualifications. We will not be able to review any resumes or other attachments. Salary Information: Unless required by legislation or union contract, starting salary is set at the lowest rate of the salary range. In most cases, successful employees will increase a step in the salary range within six months, with subsequent step increases occurring every year. In addition, the State of Ohio offers cost of living adjustments, longevity supplements after five years of public service, and wellness incentives. 5 yrs. exp. in construction & operation of natural gas pipeline systems; 1 course or 3 mos. trg. in general management; 3 mos. trg. or 3 mos. exp. in public relations; valid driver's license. * Or 5 yrs. exp. as gas pipeline safety inspector & successful completion of seven basic gas pipeline safety courses from Transportation Safety Institute; valid driver's license. * Or completion of undergraduate core program in mechanical, electrical or civil engineering; valid driver's license. * Or completion of undergraduate core program in mechanical, electrical or civil engineering technology; 3 yrs. exp. in construction & operation of natural gas pipeline systems; successful completion of seven basic Transportation Safety Institute courses in gas pipeline safety; valid driver's license. * Or completion of undergraduate core program in mechanical, electrical or civil engineering technology; 3 yrs. exp. as gas pipeline safety inspector; completion of seven basic gas pipeline safety courses from Transportation Safety Institute; valid driver's license. * Or equivalent of Minimum Class Qualifications for Employment noted above. Job Skills: Utilities