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Job Post: Senior Investigator – United Healthcare, Telecommute Dallas and/or Houston

December 07, 2022 8:14 PM | Anonymous member (Administrator)

Primary Responsibilities:

  • Investigate medium to highly complex cases of fraud, waste and abuse
  • Detect fraudulent activity by members, providers, employees and other parties against the Company
  • Develop and deploy the most effective and efficient investigative strategy for each investigation
  • Maintain accurate, current and thorough case information in the Special Investigations Unit’s (SIU’s) case tracking system
  • Collect and secure documentation or evidence and prepare summaries of the findings
  • Participate in settlement negotiations and/or produce investigative materials in support of the later
  • Collect, collate, analyze and interpret data relating to fraud, waste and abuse referrals
  • Ensure compliance of applicable federal/state regulations or contractual obligations
  • Report suspected fraud, waste and abuse to appropriate federal or state government regulators
  • Comply 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 work-groups or regulatory meetings
Apply here

Houston Area ACFE Chapter
PO Box 22853
Houston, Texas 77227-2853

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