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.
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 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.
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
- 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%
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 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 $91,700 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
