Manager of Investigations - Remote

UnitedHealth Group•Richardson, TX

7h•$91,700 - $163,700•Remote

About The Position

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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together The Manager of Investigations is responsible for the direct oversight of investigators whose primary roles are the identification, investigation and prevention of healthcare fraud, waste and abuse. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. 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.

Requirements

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 in analyzing data to identify fraud, waste and abuse trends
Advanced level of proficiency in Microsoft Excel and Word
Ability to travel up to 25%
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
Candidates are required to pass a drug test before beginning employment.

Nice To Haves

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

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 Unit’s (SIU’s) 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 compliance 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
Ability to supervise a team
Must participate in legal proceedings, arbitrations, depositions, etc.