Job Details

Manager of Investigations Remote

Join to apply for the Manager of Investigations - Remote role at UnitedHealthcare. At UnitedHealthcare, were simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do hereimpacts the lives of millions of people for the better. Join us to start Caring. Connecting. Growing together.

Youll enjoy the flexibility to work remotely from anywhere within the U.S. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities

• Managerial oversight of all types of fraud, waste and abuse cases, to include all levels of complexity
• Ensure compliance with the UnitedHealthcare (UHC) Fraud, Waste and Abuse Program
• Ability to communicate effectively, including written and verbal forms of communication
• Provide guidance to investigators on effective and efficient investigative strategies
• Ensure investigators maintain accurate, current and thorough case information in the Special Investigations Units (SIUs) case tracking system
• Participate in settlement negotiations and/or produce investigative materials in support of the latter
• Collect, collate, analyze and interpret data relating to fraud, waste and abuse
• Ensure compliance of applicable federal/state regulations or contractual obligations
• Ensure investigators comply with goals, policies, procedures and strategic plans as delegated by SIU leadership
• Collaborate with state/federal partners, at the discretion of SIU leadership, to include attendance at workgroups or regulatory meetings
• Must participate in legal proceedings, arbitrations, depositions, etc.
• Be able to supervise a team
• Be able to travel up to 25%

Required Qualifications

• Associates Degree or higher
• 5+ years of experience in health care fraud, waste and abuse (FWA) investigations/audit
• 5+ years of experience with state/federal laws and regulations pertaining to healthcare FWA
• 5+ years of experience analyzing data to identify fraud, waste and abuse trends
• Advanced level of proficiency in Microsoft Excel and Word
• Willing or ability to travel up to 25%

Preferred Qualifications

• Active affiliation with National Health Care Anti-Fraud Association (NHCAA)
• Accredited Health Care Fraud Investigator (AHFI)
• Certified Fraud Examiner (CFE)
• Certified Professional Coder (CPC)
• 2+ years of direct supervisory experience
• Specialized knowledge/training in healthcare FWA investigations
• All employees working remotely will be required to adhere to UnitedHealth Groups Telecommuter Policy

Pay and Benefits

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 401(k) contribution (all benefits are subject to eligibility requirements). The salary for this role will range from $89,900 to $160,600 annually based on full?time employment. We comply with all minimum wage laws as applicable.

Application Deadline

This posting will remain open for a minimum of 2 business days or until a sufficient candidate pool has been collected. The job posting may close early due to volume of applicants.

Equal Employment Opportunity Statement

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.

UnitedHealth Group is a drug?free workplace. Candidates are required to pass a drug test before beginning employment.