Senior Investigator
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
The Senior Investigator is responsible for identification, investigation and prevention of healthcare fraud, waste and abuse. The Senior Investigator will utilize claims data, applicable guidelines and other sources of information to identify aberrant billing practices and patterns. The Senior Investigator is responsible for conducting investigations which may include field work to perform interviews and obtain records and/or other relevant documentation.
Schedule: Monday-Friday 8:00am - 4:30pm EST
You'll enjoy the flexibility to telecommute from anywhere within New Jersey as you take on some tough challenges.
Primary Responsibilities:
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What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:
- Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
- Medical Plan options along with participation in a Health Spending Account or a Health Saving account
- Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
- 401(k) Savings Plan, Employee Stock Purchase Plan
- Education Reimbursement
- Employee Discounts
- Employee Assistance Program
- Employee Referral Bonus Program
- Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
- More information can be downloaded at: http://uhg.hr/uhgbenefits
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
- Bachelor's degree OR Associate's degree with 2+ years of equivalent work experience and healthcare related employment
- 2+ years of experience in healthcare, fraud, waste and abuse (FWA)
- 2+ years of experience in state or federal regulatory FWA requirements
- 2+ years of experience in analyzing data to identify fraud, waste and abuse trends
- Intermediate level of proficiency in Microsoft Excel and Word
- Ability to travel locally (in-state) up to 25% of the time, as needed
- Ability to participate in legal proceedings, arbitration and depositions at the direction of management
- Access to reliable transportation & valid US driver's license
Preferred Qualifications:
- Demonstrated an intermediate level of knowledge in health care policies, procedures and documentation standards or 2-5 years of experience
- Demonstrated intermediate level of skills in developing investigative strategies or 2-5 years of experience
- Specialized knowledge/training in healthcare FWA investigations
- National Health Care Anti-Fraud Association (NHCAA)
- Accredited Health Care Fraud Investigator (AHFI)
All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
#RPO #GREEN
Perks and Benefits
Health and Wellness
- HSA
- On-Site Gym
- HSA With Employer Contribution
- Health Insurance
- Dental Insurance
- Vision Insurance
- Life Insurance
- Short-Term Disability
- Long-Term Disability
- FSA
Parental Benefits
- Non-Birth Parent or Paternity Leave
- Birth Parent or Maternity Leave
Work Flexibility
- Remote Work Opportunities
Office Life and Perks
- Commuter Benefits Program
Vacation and Time Off
- Leave of Absence
- Personal/Sick Days
- Paid Holidays
- Paid Vacation
Financial and Retirement
- Relocation Assistance
- Performance Bonus
- Stock Purchase Program
- 401(K) With Company Matching
- 401(K)
Professional Development
- Promote From Within
- Shadowing Opportunities
- Access to Online Courses
- Tuition Reimbursement
Diversity and Inclusion
- Diversity, Equity, and Inclusion Program
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