[Hiring] Senior Healthcare Fraud Investigator @Piper Companies

Role Description

Zachary Piper Solutions is seeking a Senior Healthcare Fraud Investigator to support a Government Consulting company supporting the Department of Veterans Affairs (VA) Veterans Health Administration (VHA) Office of Integrity and Compliance (OIC). This position is 100% remote and focused on healthcare fraud lead development, case analysis, referral package development, and program integrity support for the VHA Fraud Rapid Response Center ("VA War Room").

Location(s): Remote (Local to Washington, DC)

Responsibilities of the Senior Healthcare Fraud Investigator:

• Review and validate fraud, waste, and abuse (FWA) leads generated through analytics platforms, including anomaly detection and network analysis tools.
• Develop investigative case packages related to community care provider fraud, coordinated billing schemes, and healthcare program integrity concerns.
• Build decision-ready referral packages supporting potential administrative actions, including provider removals, referral holds, recoupments, and oversight referrals.
• Prepare claim review workpapers, determination packages, and quality assurance documentation.
• Support case management workflow development, intake and triage procedures, case tracking, and status reporting.
• Maintain overpayment recovery, referral tracking, and oversight reporting logs.
• Provide subject matter expertise on healthcare fraud schemes, provider risk scoring, and case prioritization methodologies.
• Collaborate with VA stakeholders, OIG personnel, and program leadership to support briefings, white papers, and operational reporting.
• Assist with training materials, process improvement initiatives, and knowledge transfer activities.

Qualifications

• Bachelor's degree in a relevant field.
• 8+ years of experience supporting federal healthcare program integrity, fraud investigations, healthcare fraud referrals, and case development.
• Experience with Medicare, Medicaid, VHA healthcare programs, or related federal healthcare systems.
• Working knowledge of the False Claims Act, Anti-Kickback Statute, Stark Law, Civil Monetary Penalties Law, and HHS OIG exclusion authorities.
• Strong written and verbal communication skills for executive and senior leadership audiences.
• Ability to pass or maintain a Tier 2 / Moderate Background Investigation (MBI).
• Experience supporting healthcare fraud referrals involving HHS OIG, VA OIG, or other federal oversight organizations preferred.
• Familiarity with VA Community Care claims, provider exclusion screening, CMS program integrity data, or similar healthcare claims environments preferred.
• Experience with Palantir or similar analytics, investigative, or case management platforms preferred.
• Certified Fraud Examiner (CFE) certification preferred.
• Knowledge of CIRTS, GAO Green Book, OMB A-123, or Payment Integrity Act fraud risk frameworks preferred.

Requirements

• Salary Range: ($105,000 - $115,000).
• Comprehensive Benefits: Medical, Dental, Vision, 401(k), Paid Time Off, Holidays, and additional company-sponsored benefits.

Company Description

This job opens for applications on October 9, 2026. Applications for this job will be accepted for at least 30 days from the posting date.