Integrity & Ethics Investigations Specialist - Compliance

R1 is a leading provider of technology-driven solutions, dedicated to helping hospitals and health systems optimize their financial systems and enhance patient experiences. We stand out by integrating the expertise of a global workforce of revenue cycle professionals with the industry's most advanced technologies, including sophisticated analytics, AI, intelligent automation, and workflow orchestration.

R1 India is proud to be recognized among the Top 20 of India's Best Companies to Work For 2025 by the Great Place To Work® Institute, marking our third consecutive year of climbing the ranks - from Top 50 in 2023 to Top 25 in 2024, and now amongst the Top 20. This achievement is a testament to the exceptional workplace culture we have collectively cultivated and reflects our unwavering commitment to employee well-being, inclusion, and diversity. Our accolades also highlight our excellence in healthcare, support for millennials, women, diversity, and health and wellness.

With over 30,000 employees globally and a robust presence in India, comprising over 17,000 employees across Delhi NCR, Hyderabad, Bangalore, and Chennai, we foster an inclusive culture where every team member feels valued and empowered. Our mission is to transform the healthcare industry by driving efficiency for healthcare systems, hospitals, and physician practices, continuously striving to make healthcare work better for everyone.

The Specialist - Integrity & Ethics Investigations will be responsible for overseeing and performing confidential and sensitive compliance investigations, forensic data review, managing the intake and triage of complaints, concerns, and inquiries, documenting case information, and developing/writing reports/metrics. This person will also assist in the development of compliance/integrity training content and materials and interact with the global integrity & ethics team.  This person will report to the Associate Director, Integrity & Ethics Investigations, and will assist in the development and optimization of R1’s compliance investigation team.

Further, the senior specialist will work with the other members of the R1 data protection and privacy team by assessing, monitoring, investigating, educating on, and promoting compliance with all United States federal and state data and information privacy requirements and addressing client and operational practices. The Senior Specialist preferably will have experience with health information privacy (including, but not limited to, HIPAA), data protection and information security, healthcare compliance, regulatory analysis and interpretation, and/or compliance investigations. The Privacy Manager will also support R1’s comprehensive strategy and growth plans in helping to ensure that the company exhibits and maintains a robust data protection and privacy compliance program in safeguarding Protected Health Information (“PHI”).

In this role, the successful candidate will thoroughly investigate operational incidents, allegations related to violations in policy, and develop robust and timely case reports and metrics, as needed.

Responsibilities:

• Manage compliance investigations including data review, conducting interviews of potential witnesses and subjects of the case, and drafting investigation reports
• Assist with determining root cause analysis and recommending corrective action plans that address concerns or errors potentially discovered in the investigation
• Oversee operational matters and perform other operational reviews, ensuring they are executed in a sensitive and confidential manner and with the highest levels of integrity, efficiency, and respectability, using investigating tools and methodologies
• Manage R1’s hotline system to ensure that all incoming complaints and concerns are timely and carefully handled, and appropriate follow-up action is taken
• Assist with reviewing the compliance mailbox intake system and respond to inquiries as appropriate
• Manage the security and storage of information, evidence, and documents related to investigations
• Assist with preparing reports on investigation related metrics on an ad-hoc basis for presentation to senior management
• Assist Compliance, and HR as necessary, to ensure the effective and efficient functioning of the investigation process and any other related duties as assigned from time to time
• Stay informed of relevant compliance investigation best practices
• Assist the global Integrity & Ethics team in the development and distribution of compliance-related training materials and “integrity insights”
• Receive, document, track, investigate, and take action on potential data incidents and issues concerning compliance with applicable privacy laws and regulations and/or R1’s data protection, information security, and privacy policies and procedures;
• Ensure consistent application of sanctions for failure to comply with data protection, information security, and privacy policies in cooperation with others on the R1 data protection and privacy team, Human Resources and legal counsel, as applicable;
• Maintain focus on operational excellence through risk mitigation and protection of data to improve quality and customer satisfaction;
• Demonstrate ability and comfort working with and reporting to a broad spectrum of service lines and professionals, ranging from senior management to front line site and service leaders, including clients and vendors; and
• Flexibly assist in other areas of concern to the compliance team to benefit R1’s data protection and privacy posture.

Required Qualifications:

• Master’s Degree or PGDM or CA, LLB/LLM
• 2-4 years of investigation experience in auditing firms or with an MNC preferably in investigations or forensic analysis/auditing or experience of data protection, privacy and/or information security compliance
• Ability to read, comprehend and interpret detailed, complex written material and review data
• Ability to simultaneously consider numerous facts, perceive patterns and relationships, develop theories about past occurrences based on numerous pieces of information or evidence, compare and interpret information, recognize and examine discrepancies, and draw logical conclusions
• Ability to interview investigation subjects and witnesses and extract relevant information that is critical to an investigation
• Ability to manage time to prioritize and combine investigations when practicable to ensure timely completion
• Flexibility to work across multiple time zones when required
• Excellent writing, communication, and analytical skills
• Ability to handle several cases at one time
• Ability to demonstrate cultural sensitivity through tact and courtesy when dealing with individuals from various social, cultural, racial, and economical backgrounds
• Ability to work cooperatively as part of a team
• Ability to prepare clear, concise written reports

Desired Qualifications:

• Master’s Degree, LLB/LLM
• Relevant professional certifications such as CFE, CAMS, CCEP etc.
• Revenue cycle management experience can be an added advantage.

Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests.

Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package. To learn more, visit: r1rcm.com

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