Are you passionate about making a difference in people's lives? Do you enjoy working in a service-oriented industry? If so, this opportunity may be the right fit for you!
Modivcare is looking for an experienced Special Investigator III to join our team. As the senior member of our Special Investigations Unit (SIU), this role leads complex investigations into allegations of fraud, waste, and abuse (FWA) and internal compliance violations. The position provides mentorship and oversight to other investigators while collaborating with Legal, People & Culture, Compliance, and external stakeholders, including clients and law enforcement agencies.
Serves as lead investigator for complex or high-profile FWA and internal compliance cases.
Conducts and manages internal investigations involving policy violations, ethics concerns, and operational noncompliance.
Provides case oversight and mentorship to Special Investigator I and II team members, including reviewing documentation for quality and accuracy.
Coordinates multi-regional investigative strategies and ensures compliance with federal, state, and contractual requirements.
Analyzes data trends and case metrics to identify systemic risks and recommends corrective actions.
Develops and refines investigative protocols, templates, and best practices in partnership with leadership.
Prepares and delivers high-quality reports, executive summaries, and referral packets for clients, agencies, or internal stakeholders.
Collaborates with legal, compliance, and operational teams on investigations and remediation.
Leads regular and ad hoc status calls with clients, brokers, or law enforcement on open cases.
Acts as a subject matter expert for investigative practices, both external and internal.
Provides training to SIU staff, Compliance, and cross-functional teams on investigations and prevention.
Supports data analytics initiatives through trend identification and algorithm validation.
Represents the SIU and Compliance teams during audits and compliance reviews.
May lead cross-functional projects or serve as acting SIU Supervisor in the absence of leadership.
Provides functional direction, mentoring, and peer review for Special Investigator I and II roles.
May lead cross-functional teams on complex or high-visibility investigations.
Performs other duties as assigned.
Bachelor’s degree in Criminal Justice, Healthcare Administration, or a related field required.
Five (5) plus years of progressive experience in fraud investigations, compliance, or law enforcement.
Demonstrated experience leading or supervising investigations or project teams.
Equivalent combination of education and experience may be considered.
Expert knowledge of investigative methodologies for both external FWA and internal compliance cases.
Strong analytical and data interpretation skills.
Excellent written and verbal communication skills, with the ability to present findings to executives or regulators.
Demonstrated leadership, mentoring, and case management abilities.
Proficiency with case management systems and data visualization tools (e.g., Power BI, Excel).
High level of integrity, discretion, and sound judgment when handling sensitive or confidential information.
Ability to manage multiple investigations concurrently and deliver timely, high-quality outcomes.
Salary: $52,900 - $71,400
Modivcare’s positions are posted and open for applications for a minimum of 5 days. Positions may be posted for a maximum of 45 days dependent on the type of role, the number of roles, and the number of applications received. We encourage our prospective candidates to submit their application(s) expediently so as not to miss out on our opportunities. We frequently post new opportunities and encourage prospective candidates to check back often for new postings.
We value our team members and realize the importance of benefits for you and your family.
Modivcare offers a comprehensive benefits package to include the following:
Modivcare is an Equal Opportunity Employer.