Public Partnerships
Fraud Audit & Investigations Specialist
US Remote · Mid
Sponsorship not specified$63k-$83kDetected 5 days ago
Account ManagementOutbound SalesAuditingCommunication
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odds of building a lasting career here
39Risky
Cap-exempt (no lottery)0
Sponsors this role90
Entry-level history0
PERM / green-card track0
Lottery odds (Level I)39
Fits your clock70
Thin sponsorship signal and lottery-bound (~15% per draw). A low-probability bet with your clock running. Prioritize cap-exempt roles and proven entry-level sponsors first.
Lottery odds assume a STEM candidate.
Personalize to your clock →Employer immigration record
from this employer's Department of Labor filings
Green-card filing pattern in this occupation
Context, not a finding about this posting: of this employer's 7 green-card filings in this occupation, 100% were for a worker who already held the job.
Green-card follow-through: 67%
Of 6 labor certifications old enough to have been used, 2 expired without the employer filing the next step. Median time from filing to decision: 506 days.100% of their filings were for a worker who already held the job.Only certifications past the 180-day window are counted — recent ones cannot have expired yet.
Files H-1B transfers
1 transfer filing in the last year, covering 1 worker. Median labor-condition decision: 7 days. An employer that already files transfers is one that can take over an existing H-1B.
Sourced from Department of Labor LCA, PERM and prevailing-wage disclosure data. Employer matching is by name, so figures may be split across an employer's legal entities. Absence of a filing means none appears in our copy of the data, not that none exists.
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About the role
- The Fraud Audit & Investigations Specialist provides administrative and analytical support to the FWA Analyst and Senior Manager, Program Integrity, in conducting fraud, waste, and abuse (FWA) investigations and contributes to the team's audit and regulatory deliverable work.
- Operating under general direction from the Senior Manager, this role assists with intake, documentation, and tracking of moderate-complexity investigations, helps prepare and organize supporting documentation for regulator-ready case files, and provides support to the Analyst and Senior Manager on more complex, high-risk, or multi-agency matters and on regulatory deliverables.
Responsibilities
- Coordinate with cross-functional teams, including analytics, compliance, legal, and account management staff to gather and validate information that drives case resolution.
- Documentation, Quality and Team Support
- Pull and analyze conflict reports to identify possible scheduling overlaps and collaborate with other teams and appropriate staff to investigate and resolve discrepancies as necessary.
- Run and distribute daily and recurring reports, and provide general administrative support to the team as needed
- Maintain assigned entries in the RFI tracking log, including status updates and documentation of deadlines
- Support preparation for external audits and assessment requests as directed
Requirements
- Education: Bachelor's degree preferred; substantial professional experience may be considered in lieu of a formal degree.
Nice to have
- Bachelor's degree preferred
- substantial professional experience may be considered in lieu of a formal degree.
- Prior experience in fraud investigations, program integrity, or compliance auditing preferred
- Experience preparing or responding to regulatory RFIs, audits, or CAP documentation preferred
- Experience with consumer-directed care programs (e.g., CDPAP) strongly preferred
Skills
- Actual compensation will be determined based on a variety of factors, including skills, experience, and geographic location.
- It is not intended to be construed as an exhaustive statement of all duties, responsibilities, or skills of personnel so classified
Compensation
- $63,000 - $83,000
- This role is eligible for a base salary within the posted range.
- Actual compensation will be determined based on a variety of factors, including skills, experience, and geographic location.
- Compensation may vary for positions based in high cost-of-labor markets.
- At PPL, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications.
Benefits
- Support the FWA analyst to conduct standard and moderate-complexity investigations into suspected fraud, waste, and abuse referred from analytics, hotline reports, or health plan/regulator referrals
- Assemble and organize documentation for assigned portions of Requests for Information (RFIs) from MFCUs, OMIG, health plans, and other regulators or auditors, under the direction of the Analyst or Senior Manager
- Develop and apply working knowledge of LHCSA agency operations, MCO/health plan compliance and SIU functions, and state regulator expectations
- Support the Analyst and Senior Manager on shared investigations and referral processes with MCO/health plan SIU and compliance counterparts
Company info
- We are appointed by states and managed healthcare organizations to better serve more of their residents and members requiring long-term care and ensure the efficient use of taxpayer funded services.
- Our culture attracts and rewards people who are results-oriented and strive to exceed customer expectations.
Equal opportunity
- PPL is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion.
Visa & Work Authorization
- disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any
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This listing is sourced directly from Public Partnerships's careers page and normalized into a canonical job model.