Healthcare Compliance Investigator, Yale Health

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Overview
In 1971, Yale University established Yale Health to provide health services to its facility, staff and students through a multidisciplinary health maintenance organization located on campus. Yale Health has more than 50,000 members including students, staff, faculty and their families who come from every state in the country and almost every country in the world. With over 50 years of service to the Yale community, our state-of-the-art facility at 55 Lock Street, is where our members receive most of their care from our 150+ providers. It is a 144,000 square foot medical facility with over 90 exam rooms, an Acute Care Department, a 15-bed inpatient facility with two negative pressure rooms, a diagnostic imaging suite including MR and CT scan, x-ray and ultrasound and a full-service retail pharmacy.

Reporting to the Senior Director of Compliance & Privacy Officer, the Compliance Investigator serves as Yale Health's lead investigator for complex, sensitive, and high-risk compliance, privacy, regulatory, and ethical matters. This position plays a critical role in protecting the integrity of Yale Health's operations by ensuring concerns are promptly, thoroughly, and objectively investigated and that appropriate corrective actions are identified to mitigate organizational risk.

The Compliance Investigator is responsible for independently managing investigations from initial intake through final resolution, including assessing allegations, developing investigative strategies, conducting interviews, analyzing evidence and preparing investigative findings. Matters under review may involve alleged violations of federal and state laws, healthcare regulations, University policies, privacy requirements, professional standards of conduct, conflicts of interest, fraud, waste and abuse, or other compliance-related concerns.

As a subject matter expert in investigatory practices, regulatory compliance, and risk mitigation, the Compliance Investigator partners closely with Yale Health leadership, Human Resources, the Office of General Counsel, Compliance & Privacy, and other stakeholders to ensure investigations are conducted with professionalism, fairness, objectivity, and confidentiality. The position also identifies emerging compliance risks, supports regulatory readiness, assists with policy development, participates in audits and compliance initiatives, and helps strengthen Yale Health's culture of accountability, integrity, and ethical conduct.

This role requires exceptional analytical ability, sound judgment, discretion, and the ability to navigate highly sensitive matters involving employees, providers, patients, students, and external regulatory agencies. The successful candidate will be equally comfortable conducting detailed fact-finding investigations, interpreting complex regulatory requirements and communicating findings to leadership.

Responsibilities include:

• Consults with management, Office of General Counsel, Human Resources and/or the Sr. Director of Compliance & Privacy Officer as needed to resolve difficult, highly sensitive or complex compliance issues.

• Independently evaluates and assesses allegations to determine whether laws, policies or regulations have been violated.

• Plans and conducts complex, confidential internal investigations from inception to conclusion. This includes defining investigation strategy, preserving evidence, conducting interviews, analyzing records, conducting root cause analysis, and recommended corrective actions.

• Conducts, manages, and documents interviews with internal witnesses, as required for investigatory purposes.

• Identifies risks, interprets investigation results, and recommends and communicates corrective actions to mitigate future potential risks.

• Performs follow up to ensure remedial / disciplinary measures are implemented appropriately and timely.

• Plans, develops, leads, and manages multiple projects, including prioritizing and managing through execution.

• Maintains meticulous case files and chronologies in accordance with best practices and record retention laws.

• Thoroughly documents, organizes, and reviews case files, relative to each investigation in accordance with University policy.  Prepares clear and concise draft investigation plans and reports.

• Attends, actively participates in, and/or leads meetings with various business area managers.

• Communicates directly with Federal or State regulators.

• Supports the development and maintenance of Compliance & Privacy policies, procedures and workflows.

• Participates in and leads special projects (e.g., auditing, training, HIPAA & FERPA compliance).

• Provides support and guidance to other team members.

• Complies with all University policies and standards.  

• Performs other duties as assigned.

Schedule/Shift: Full-time, 37.5 HRS.  Generally scheduled M-F, 8:30 am – 5:00 pm.  Evenings, weekends, holidays and recess periods may also be required. 

Required Skills and Abilities

1.  Ability to maintain strict confidentiality of sensitive information with professionalism and discretion.

2.  Excels at multitasking, balancing accuracy and attention to detail in fast-paced, interruption-heavy environments.  Exercises sound judgment, prioritizes effectively, and anticipates needs to meet deadlines with initiative and problem-solving.

3.  Demonstrates strong interpersonal skills and a customer service mindset, working effectively with diverse stakeholders.

4.  Delivers clear, professional communication—oral and written—with strong organizational and analytical abilities. 

5. Proficient in Microsoft Office Suite (Word, PowerPoint, Excel, databases), with strong internet research skills.

6. Proficient in using the electronic health record (EHR) systems, preferability EPIC.

7. Excellent attendance, punctuality and reliability. 

Preferred Skills and Abilities

Master’s Degree;  Bachelor’s degree in criminal justice, healthcare or public administration, English or related field of study; Previous experience as an investigator in a healthcare environment;  6+ years progressive experience in conducting and managing complex investigations or auditing and risk analysis; 6+ years' experience reading, analyzing and interpreting State and Federal laws, rules and regulations;  Certified in Healthcare Compliance (CHC); Certified in Healthcare Privacy Compliance (CHPC); Certified Compliance & Ethics Professional (CCEP) or similar certification.

Principal Responsibilities

 

1.  Participate and/or take lead role in planning, organizing, and executing confidential investigative audits and other special assignments; conduct interviews of departmental personnel; examine relevant documentation and verify internal control procedures. Develop, implement, and execute audit programs and procedures relating to a wide variety of University activities. Research and analyze transactions and other relevant information and identify potential policy violations or other anomalies. Interview individuals that are the subject of investigations or who possess specialized knowledge related to the case  Document audit work and draft reports detailing audit recommendations for management. 2.  Prepare written reports that summarize the audit work and identify system control weaknesses and the related risks if any. Develop conclusions that may be used to make key personnel decisions and business decisions. In conjunction with business managers and department heads, develop solutions and action plans to address areas requiring improvement. Act as a catalyst for identifying root causes and constructive changes to administrative systems and control procedures. Present investigation results to upper management as deemed necessary. 3.  Prepare materials to support and/or testify at grievance hearings or legal proceedings. 4.  Work closely with members of other University Departments, including the Office of the General Counsel, Human Resources, and the Yale Police. 5.  Handle difficult and sensitive matters with the highest level of confidentiality and discretion. 6.  Manage and oversee projects conducted by Senior Auditor – Special Projects and Investigations and other Audit staff when necessary; Manage external consultant activities when necessary. 7.  Influence the development of policies and procedures for the University through the effective presentation of the audit results to the administration. 8.  May conduct internal operational and financial audits. 9.  Research audit related topics and issues using web-based tools that provide access to information available from state and federal agencies, higher education industry groups, professional organizations and other authoritative sources. 10. Perform other duties as assigned, including operational and financial audits. Required Education and Experience Bachelor's degree in finance, accounting or business administration and eight years of previous experience in financial or operational auditing or equivalent combination of education and experience.

Job Posting Date

07/10/2026

Job Category

Manager

Bargaining Unit

NON

Compensation Grade

Administration & Operations

Compensation Grade Profile

Senior Manager; Senior Program Leader (26)

Salary Range

$92,000.00 - $146,750.00

Time Type

Full time

Duration Type

Staff

Work Model

On-site

Background Check Requirements

All candidates for employment will be subject to pre-employment background screening for this position, which may include motor vehicle, DOT certification, drug testing and credit checks based on the position description and job requirements. All offers are contingent upon the successful completion of the background check. For additional information on the background check requirements and process visit "Learn about background checks" under the Applicant Support Resources section of Careers on the It's Your Yale website.

Health Requirements

This role is a healthcare worker position. Healthcare workers (HCW) are defined as university employees working a healthcare setting who have the potential for direct or indirect exposure to patients, human research subjects or infectious materials including body substance, contaminated medical supplies, devices and equipment, surfaces, or air.  HCW have specific health requirements that must be met prior to starting work, including MMR vaccine or immunity, varicella (chickenpox) vaccine or immunity, TB screening, COVID vaccine according to University policy, hepatitis B vaccine or immunity, and annual flu vaccination.

Posting Disclaimer

Salary offers are determined by a candidate’s qualifications, experience, skills, and education in relation to the position requirements, along with the role’s grade profile and current internal and external market conditions.

The intent of this job description is to provide a representative summary of the essential functions that will be required of the position and should not be construed as a declaration of specific duties and responsibilities of the position. Employees will be assigned specific job-related duties through  their hiring department.

The University is committed to basing judgments concerning the admission, education, and employment of individuals upon their qualifications and abilities and seeks to attract to its faculty, staff, and student body qualified persons from a broad range of backgrounds and perspectives. In accordance with this policy and as delineated by federal and Connecticut law, Yale does not discriminate in admissions, educational programs, or employment against any individual on account of that individual’s sex, sexual orientation, gender identity or expression, race, color, national or ethnic origin, religion, age, disability, status as a special disabled veteran, veteran of the Vietnam era or other covered veteran.

Inquiries concerning Yale's Policy Against Discrimination and Harassment may be referred to the Office of Institutional Equity and Accessibility (OIEA).

Note

Yale University is a tobacco-free campus.