14 days old

Compliance Investigator

Kaiser Permanente
Portland, OR 97232

Responsible for investigations of potential violations. Develops and presents findings and recommendations for corrective action and working with business departments and Compliance staff to ensure they are developed and completed according to established timelines; Identify opportunities for systemic corrective action and recommend changes to policies/operational practices to reduce recurrence of complaints.

Essential Responsibilities:
  • Conduct investigations related to privacy and security issues, fraud/waste/abuse issues, violations of Principles of Responsibility, allegations of retaliation, conflict of interest and other allegations of compliance violations. Responsible for conducting a thorough investigation within timeframes and according to quality standards. Identify witnesses, assess credibility and conduct and document interviews of those witnesses. Review, interpret, analyze and evaluate statements, documents and physical evidence collected during investigation to apply to investigation plan, investigation report/response. Develop and apply knowledge of whistle-blowing laws, rules of evidence and makes determinations regarding violations of law or KP policy. Prepare investigative reports and corrective action plans. Partner with management, Human Resources and legal counsel regarding action plans resulting from investigative findings. Identify, gather, document and preserve all forms of evidence in accordance with rules of evidence and organizational policies. Identify, track and document organizational losses, recoveries and avoidances. Track, monitor and report investigation progress and closure in the national tracking database. Escalate investigations when necessary to minimize risk exposure to the organization.
  • Identify and monitor trends of investigative activity by business unit and other parameters. Develop and create reports and tools to analyze and respond to trends of reports of non-compliance for use by Compliance Department management, Regional Compliance Committee, National Compliance Office, Senior Leadership and other audiences. Develop policy and operational improvements and influence implementation of programs, strategies and other collaborative activities to prevent recurrence of complaints.
  • Develop and conduct fraud/waste/abuse risk assessments to assure compliance with state and federal regulations, policies and procedures and safeguard organizational assets.
  • Work with NSIU investigators and provide support for compliance investigations.
  • Research and respond to inquiries/ request for information from law enforcement, state and federal regulators. Provide testimony at hearings, depositions and trials.
  • Work closely with Permanente Medical Group (PMG)  to ensure reports of non-compliance involving employees of PMG are investigated and resolved.
  • Other duties as assigned.
  • Posted: 2020-02-10 Expires: 2020-03-22

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    Compliance Investigator

    Kaiser Permanente
    Portland, OR 97232

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