Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country.
Qlarant has exciting opportunities for experienced Unemployment Fraud Investigators. These positions are home based. The preferred location is the State of Nevada, but other locations will be considered. Please note: This position is contingent upon contract approval.
This position independently performs in-depth evaluation and makes field level judgments related to investigations of potential Unemployment Insurance fraud, waste and abuse investigations or cases that meet established criteria for referral for criminal action.
Essential Duties and Responsibilities include the following. Other duties may be assigned
- Utilizes leads provided by the team and referrals from government and private agencies, works with the team to prioritize complaints for investigation, and then investigates, conducts interviews and reviews information to make potential fraud determination.
- Determines investigation or case appropriateness of fraud, waste and abuse issues in accordance with pre-established criteria.
- Based on contract requirements, may refer potential adverse decisions to the Lead Investigator/Manager or designee.
- Conducts interviews of witnesses, informants, and subject area experts and targets of investigations.
- Identifies, collects, preserves, analyzes and summarizes evidence, examining records, verifying authenticity of documents, may provide information to support the preparation of attestations/referrals or supervising the preparation of attestations/referrals as needed.
- Drafts investigation reports, evaluates investigation reports, and promotes effective and efficient investigations.
- Initiates and maintains communications with law enforcement and appropriate regulatory agencies including presenting or assisting with presenting investigation or case findings for their consideration to further investigate, prosecute, or seek other appropriate regulatory or administrative remedies.
- Testifies at various legal proceedings as necessary.
- Identifies opportunities to improve processes and procedures.
- Has the responsibility and authority to perform their job and provide customer satisfaction.