[All remote jobs](https://jobicy.com/jobs.md)[![Arlo Solutions logo](https://jobicy.com/data/server-nyc0409/galaxy/mercury/2025/06/0a3b43a1-221.jpeg)](https://jobicy.com/company/arlo-solutions.md)[Arlo Solutions](https://jobicy.com/company/arlo-solutions.md) # (763) Senior Healthcare Fraud Investigator Review the role, location requirements, compensation details, and application process before deciding whether this opportunity fits your next career move. [Apply for this job](#job-application)[View company](https://jobicy.com/company/arlo-solutions.md)ShareRemote from[USA](https://jobicy.com/job-region/usa.md)SalaryUndisclosedDepartment[Legal & Compliance](https://jobicy.com/categories/legal.md)EmploymentFull TimeExperienceDirectorPublished20 Oct 2026Apply before19 Nov 2026Listing views52Application actions3Application toolkit ## Make your next move. Prepare your resume, explore your fit, and draft a cover letter for this opportunity. AI Summary ## The role, at a glance. Senior Healthcare Fraud Investigator supports the VA Veterans Health Administration Fraud Rapid Response Center by developing and documenting healthcare fraud, waste, and abuse leads. The role converts analytics from Palantir and related sources into evidence-based weekly referral packages, claim-review workpapers, and leadership-ready recommendations. It also contributes to case workflows, recovery tracking, fraud-risk criteria, SOPs, and knowledge transfer for VA personnel. This is an advisory contractor role working under active direction from federal investigators; government personnel retain final investigative and referral decisions. ## Role DNA A quick view of the complexity, pace, ownership and collaboration implied by the job description. ### Job Complexity 5/5EasyHard ### Pace & Pressure 5/5RelaxedFast-paced ### Autonomy Level 4/5GuidedFull ownership ### Communication Load 5/5IndependentCollaborative AI insightThe position requires deep federal healthcare program-integrity expertise, knowledge of major fraud statutes, and the ability to translate complex analytical signals into defensible case documentation. Weekly decision packages, high-level oversight, and coordination with VA and OIG stakeholders create a demanding, high-visibility environment. ## Salary analysis Estimated compensation compared with the broader US market for similar roles. Estimated job median (per year)Market rate$140,000US market range (per year)$120k–$165k0$181.50k AI insightThe yearly pay period is inferred from the job context; it was not explicitly stated by the employer. No employer compensation is disclosed. Estimated annual USD compensation for a senior federal healthcare fraud investigator supporting VA program-integrity operations is approximately $120,000–$165,000, with a midpoint estimate of $140,000; yearly cadence is inferred from the senior full-time US consulting role. ## Core skills Skills and capabilities most closely associated with this opportunity. [Healthcare fraud investigations](https://jobicy.com/jobs?search_keywords=Healthcare%20fraud%20investigations.md)[Federal program integrity](https://jobicy.com/jobs?search_keywords=Federal%20program%20integrity.md)[Fraud waste and abuse analysis](https://jobicy.com/jobs?search_keywords=Fraud%20waste%20and%20abuse%20analysis.md)[Healthcare claims review](https://jobicy.com/jobs?search_keywords=Healthcare%20claims%20review.md)[Case development](https://jobicy.com/jobs?search_keywords=Case%20development.md)[False Claims Act](https://jobicy.com/jobs?search_keywords=False%20Claims%20Act.md)[Anti-Kickback Statute](https://jobicy.com/jobs?search_keywords=Anti-Kickback%20Statute.md)[Stark Law](https://jobicy.com/jobs?search_keywords=Stark%20Law.md)[Referral package preparation](https://jobicy.com/jobs?search_keywords=Referral%20package%20preparation.md)[Evidence documentation](https://jobicy.com/jobs?search_keywords=Evidence%20documentation.md)[Provider risk scoring](https://jobicy.com/jobs?search_keywords=Provider%20risk%20scoring.md)[Palantir analytics](https://jobicy.com/jobs?search_keywords=Palantir%20analytics.md)[Case management workflows](https://jobicy.com/jobs?search_keywords=Case%20management%20workflows.md)[Executive briefing](https://jobicy.com/jobs?search_keywords=Executive%20briefing.md)[Stakeholder collaboration](https://jobicy.com/jobs?search_keywords=Stakeholder%20collaboration.md) Sample interview questionsHow would you turn an analytics-generated provider anomaly into a decision-ready fraud referral package?I would first validate the signal through claim-level, provider, beneficiary, and network-context review. I would document the relevant facts, methodology, supporting records, risk indicators, and limitations, then connect the evidence to the potential administrative or oversight action. The final package would provide a concise recommendation, traceability to source data, and a clear distinction between observed evidence and conclusions reserved for government investigators. What healthcare fraud schemes would you prioritize when reviewing community care provider claims? I would assess indicators of upcoding, unbundling, medically unnecessary services, duplicate billing, billing for services not rendered, abnormal utilization, excluded providers, and coordinated billing relationships. I would prioritize schemes using potential financial exposure, patient-safety implications, recurrence, strength of evidence, and the feasibility of prompt administrative action. How do you ensure claim-review workpapers are defensible and reproducible? I use a structured workpaper format that identifies the data source, review population, sampling method where applicable, claim-selection rationale, governing criteria, calculations, evidence references, and quality-control checks. I also maintain an audit trail so another reviewer can reproduce the analysis and understand any assumptions or exceptions. Describe how you would work within the boundary that federal investigators retain final case decisions. I would provide analytical and documentation support only under active federal investigator direction. My work would focus on organizing evidence, validating data, preparing draft packages, and identifying questions or risk indicators, while clearly avoiding unauthorized case openings, findings, or referral decisions. I would use defined handoffs and escalation paths to ensure accountability remains with authorized government personnel. How would you communicate a complex fraud pattern to executive leadership? I would lead with the operational decision required, the estimated exposure, the affected provider or claim population, and the recommended next step. Supporting detail would be organized into a brief evidence narrative, visual trend summaries where useful, key assumptions, and a concise explanation of risks and limitations. This gives leaders a clear, fact-based basis for action without overstating investigative conclusions. Opportunity details ## About this role. Company Summary Arlo Solutions (Arlo) is an information technology consulting services company that specializes in delivering technology solutions. Our reputation reflects the high quality of the talented Arlo Solutions team and the consultants working in partnership with our customers. Our mission is to understand and meet the needs of both our customers and consultants by delivering quality, value-added solutions. Our solutions are designed and managed to not only reduce costs, but to improve business processes, accelerate response time, improve services to end-users, and give our customers a competitive edge, now and into the future. Position Description: Arlo Solutions is supporting the Department of Veterans Affairs (VA) Veterans Health Administration (VHA) Office of Integrity and Compliance (OIC) in standing up and running the VHA Fraud Rapid Response Center (“VA War Room”). The War Room uses data analytics, fraud risk assessment and fast administrative action to protect Veterans and taxpayer dollars, in line with Executive Orders 14395 and 14243. The work gets high-level oversight and reporting to the White House, Congress, the Secretary of Veterans Affairs and the Under Secretary for Health. The Senior Healthcare Fraud Investigator leads healthcare fraud lead and case development from day one, turning analytic leads from VA’s Palantir platform into weekly, decision-ready War Room referral packages. The role is advisory and analytical. All final decisions stay with Government personnel. Location: REMOTE – Local to Washington, DC Clearance: Minimum Background Investigation Responsibilities and/or Success Factors: Fraud Lead & Case Development: * Review and validate anomalies and prioritized leads from the War Room analytics (including Provider 360, anomaly detection and network analysis). * Develop cases for potential community care provider fraud, waste and abuse (FWA) and coordinated billing schemes. Referral Package Development: * Build War Room referral packages with documentation that supports potential administrative actions, such as provider removals, referral holds, recoupments and referrals to oversight bodies. Weekly Decision Packages: * Help produce weekly analytic runs and decision-ready case packages that include facts, analysis, a recommendation and traceability. Claim Review Workpapers: * Prepare claim review workpapers and determination packages and apply case-file QA checklists and sampling plans. Case Management Workflow: * Help design the end-to-end case workflow from intake to closure, including roles, handoffs, SLAs and escalation paths, aligned with CIRTS triage practices. * Contribute to the intake and triage SOPs, the case lifecycle and status taxonomy, and standard investigation templates. Overpayment & Referral Tracking: * Keep the overpayment, recovery and referral status tracking register and the oversight and tracking log up to date. Algorithm & Scheme Input: * Give investigative subject-matter input on FWA scheme typologies, rule logic, provider risk-scoring and case-prioritization criteria. Federal Investigator Direction (IGF Boundary): * Do case documentation and evidence work only under real, active direction from a federal investigator. No opening cases, making findings or making referral decisions. Stakeholder Collaboration: * Work closely with OIC staff, VA OIG and VHA stakeholders. * Support ad hoc white papers, outcome summaries and leadership briefings. Knowledge Transfer: * Help with training materials, kaizen sessions, after-action debriefs and knowledge transfer so VA staff can run War Room operations on their own by contract end. Minimum Qualifications Including Certificates: * Bachelor’s degree in a relevant field – 8+ years of federal healthcare program integrity and fraud investigations experience, such as Medicare/Medicaid and VHA healthcare fraud referrals and case development * Working knowledge of healthcare fraud law: the False Claims Act, Anti-Kickback Statute, Stark Law, Civil Monetary Penalties Law and HHS OIG exclusion authorities * Strong written and verbal communication for executive-level audiences * Able to pass or hold a Tier 2 / Moderate Background Investigation (MBI) Desired Qualifications: * Certified Fraud Examiner (CFE) certification * Current or prior VA/VHA system access, or current active VA contractor status * Experience working with HHS OIG, VA OIG or other federal law enforcement on healthcare fraud referrals * Experience with VA Community Care claims, CMS program integrity data or provider exclusion screening * Familiarity with Palantir or similar analytics and case-management platforms * Experience with CIRTS or similar compliance case-tracking systems Knowledge of GAO Green Book, OMB A-123 and Payment Integrity Act fraud risk frameworks AAP Statement We are proud to be an Affirmative Action and Equal Opportunity Employer and as such, we evaluate qualified candidates in full consideration without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, age, disability status, protected veteran status, and any other protected status. Show more [Apply now >](https://jobicy.com/jobs/156079-763-senior-healthcare-fraud-investigator.md) > Annual salary information is not provided for this position. 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