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UnitedHealth Group

UnitedHealth Group is looking for a Sr Investigator – OptumServe Payment Integrity – Telecommute  #BestJobsNearPagosaSprings #JobsHiringNowInPagosaSprings

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that’s improving the lives of millions. Here, innovation isn’t about another gadget, it’s about making health care data available wherever and whenever people need it, safely and reliably. There’s no room for error. Join us and start doing your life’s best work.(sm)Youll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities: Triage Fraud, Waste, and Abuse (FWA) forms to distinguish potential FWA from non FWA issues Route non FWA issues to the appropriate department for follow-up Initiate investigative procedures of potential FWA by creating the case file, loading the case into the case tracking tool, verifying provider data, and extracting data for review Identify trends of fraud, waste, and abuse and evaluate cases for indicators Run weekly and quarterly reports out of the case tracking tool. Manage the filing, distribution and follow-up as needed Coordinate and assist with Subpoena fulfillment Assess investigative findings and/or other case related data to determine patterns of potential fraud, waste, and abuse Assist with the investigative process as neededYoull 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: Four-year degree in any field 3+ years of experience in the health care industry, in auditing, claims processing or payment integrity 3+ years of experience investigating or analyzing FWA in the Federal space 3+ years of health care data analysis and interpretation 2+ years of experience conducting comprehensive research Proficiency using Microsoft Word, Excel, and Outlook Experience working well in a remote team environment, to collaborate with others, and interface with team members internal and external to the organization Experience working independently to meet predefined production and quality standards Federal clearance Preferred Qualifications: Ability to communicate clearly and professionally with all levels of the organization, both written and verbal Flexibility and ability to plan, prioritize, and execute multiple tasks in a fluid environment Self-motivated, well-organized, and detail oriented Ability to maintain a high level of confidentiality and integrity Experience working in Federal Contracts Ability to evaluate State and Federal regulations/guidelines DB2/SQL experience Proficiency in research, analysis, interpretation, and application of healthcare regulations and policies Ability to perform well in a team environment, with staff at all levels, to achieve business goals Basic level of knowledge of health care data analysis, claims auditing or medical claims codingCareers with Optum. Here’s the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world’s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life’s best work.(sm)OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCares support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.Colorado Residents Only: The salary range for Colorado residents is $53,300 to $95,100. 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, youll find a far-reaching choice of benefits and incentivesDiversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employmentJob Keywords:  FWA, federal, health care, auditing, claims processing, payment integrity, data analysis, investigator, fraud, Telecommute, Remote, Work from Home Recommended SkillsCoordinatingAttention To DetailSelf MotivationAnalysisResearchReportsRecommended JobsAnalystPayment AnalystAtlanta,GaPayment Analyst, Atlanta,GaSr Investigator – OptumServe Payment Integrity – TelecommuteUnitedHealth GroupWork From HomeFull Time
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