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Sr Data Investigator - Telecommute

Company: UnitedHealth Group
Location: Charlotte
Posted on: September 24, 2022

Job Description:

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) As a Sr Data Investigator with us, you will monitor patterns of potential fraud, waste and/or abuse to ensure compliance and be closely involved in the investigation process. It will definitely be a whirlwind, but it will also be the place where you can help make the health system work better with the support and resources of a Fortune 6 leader. - If you call yourself a data guru, then you'll be perfect for this role. As you respond to inquiries, requests and actions, you'll need to be able to communicate research and data findings in a meaningful way. You will also be responsible for monitoring internal and external regulatory audits. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities:

  • Fraud Lead generation by analyzing and interpreting data to identify trends, patterns and opportunities for the business and clients
  • Perform data manipulation activities for the fraud investigations team including data extracts, summaries, random sampling, and special projects
  • Prepare Healthcare claims data for investigative business needs and work with investigations teams to better understand the content of the data sets
  • Establish and implement standard policies, procedures processes and best practices across the company to promote compliance with applicable laws and contractual obligations
  • Conduct state-specific legal research and assist with modifying report requirements to mitigate risks and achieve compliance
  • Support the collection of data for SIU (Special Investigations Unit) activities and generate routine regulatory and executive level reports for distribution
  • Produce, publish and distribute scheduled and ad-hoc client and operational reports relating to the development and performance of products, processes and technologies 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:
    • Undergraduate degree or equivalent work experience
    • 1+ years of experience in creating and using data modeling tools, spreadsheets, and information acquisition tools
    • Advanced proficiency within Excel (advanced formulas, pivot tables, macros, lists, statistical functions, etc.)
    • Intermediate proficiency with MS Office (Word, PowerPoint and Outlook
    • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation Preferred Qualifications:
      • Industry Certification (CFE, AHFI, CPC)
      • Experience working in a government, legal, health care, managed care and/or health insurance environment in a regulatory, privacy or compliance role
      • Experience communicating complex information via phone conversations and emails to non-technical clients, external customers, internal customers and executives
      • Experience working independently and researching regulations
      • SQL experience -
      • Python coding experience
      • SAS coding and/or SAS EG experience
      • VBA (visual basic for application) experience -
      • Tableau experience - To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm) Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $54,400 to $97,000. The salary range for Connecticut / Nevada residents is $60,000 to $106,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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. *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. 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.

Keywords: UnitedHealth Group, Charlotte , Sr Data Investigator - Telecommute, Other , Charlotte, North Carolina

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