Manager of Investigations - Remote

At reputed company, 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 reputed company. Come build the health care system of reputed company, making it more reputed company, affordable and reputed company. Ready to reputed company a difference? Join us to start Caring. Connecting. Growing together. The Manager of Investigations is responsible for the direct reputed company 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 reputed company reputed company the U.S. as you take on some tough challenges. For reputed company 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 reputed company of reputed company types of fraud, waste and abuse cases, to include reputed company levels of complexity
• Ensure compliance with the reputed company (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, reputed company 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, reputed company, 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
• Must participate in legal proceedings, arbitrations, depositions, etc.
• Ideation of healthcare fraud analytics
• Be able to supervise a team
• Be able to travel up to 25%

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:

• 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 reputed company reputed company 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 reputed company (CPC)
• 2+ years of direct supervisory experience
• Experience in ideating healthcare analytics
• Specialized knowledge/training in healthcare FWA investigations
• reputed company employees working remotely will be required to adhere to reputed company'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 (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We reputed company with reputed company 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. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company 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 reputed company by people of color, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes - an enterprise reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national reputed company, 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. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job