Investigations Data Consultant - National Remote

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.

As an Investigations Data Consultant, you'll review claims data, look for patterns of potential fraud, waste and/or abuse and interact with the Special Investigations Unit ("SIU") to complete investigations. You'll be fully invested in the outcomes and will be helping the health system work better for everyone with the support and resources of a Fortune 5 industry leader.

You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Establish, mandate, implement standard policies, procedures and best practices regarding UnitedHealthcare Investigations' claim sampling and extrapolation methodologies and other tasks as delineated by UnitedHealthcare Investigations' Leadership
• Support and perform the collection of data for investigation needs, identify investigative data universe, perform statistically valid random sampling, coordinate and develop reports, projects, using well established knowledge of health care related data manipulation tools
• Predict and detect emerging health care fraud trends and develop innovative technological solutions to identify them
• Conduct state and federal legal research and monitor changes in requirements to mitigate risks and achieve compliance
• Develop compliance communications and drive problem resolution for a business segment across UnitedHealth Group
• Assist other team members in researching and investigating potential fraud, waste and/or abuse cases
• Supervising 3-4 direct reports

Analyzing the sheer magnitude of investigative findings will be the toughest part of your role. You will serve as a subject matter expert in uncovering common themes, recovery and testimonials. You will do limited field work, primarily reporting on patterns trending in investigations.

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 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:

• Bachelor's Degree in a related area of study
• 5+ years of experience working in a government, legal, health care, managed care and/or health insurance environment in a regulatory, privacy, compliance, or investigation's role
• 5+ years of experience communicating complex information via phone conversations and emails to non-technical clients, external customers, internal customers and executives
• 5+ years of experience interacting and collaborating with a variety of stakeholders (other team members, internal customers, and executives)
• Advance proficiency with MS Excel and Statistical Sampling Tools (example - RAT STATS) and methodologies
• Intermediate level of proficiency with MS Word, MS Outlook, MS Access, SQL, SAS and VBA

Preferred Qualifications:

• Experience working with Medicare, Medicare Advantage, Medicare Part D, Medicaid and/or Tricare regulations
• Familiarity with "big" data manipulation tools such as SAS, Toad, Python, Tableau, Alteryx etc.
• Familiarity with statistical tools in healthcare
• Familiarity with software engineering

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

The salary range for this role is $71,600 to $140,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

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.

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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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

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