Investigator

Investigator The Investigator will be responsible for investigating agent/broker complaints across all lines of business in accordance with state and federal regulations. Travel: 0-10%. Schedule: Monday-Friday, standard business hours. No nights, no weekends and no holidays. You will be able to telecommute* from anywhere within the U.S. Primary Responsibilities Conduct confidential compliance investigations related to agents/brokers across all lines of business. Document all relevant findings in written reports. Utilize information from plan members (interviews), agents/brokers, sales operations, claims data, and internal systems. Conduct and document interviews (by telephone and in person) for all parties involved in an investigation. Report any illegal activities in accordance with all laws and regulations. Act as a subject matter expert by identifying and communicating relevant findings to the business. Where applicable, provide testimony regarding the investigation. Responsible for generating independent work product. Required Qualifications High School Diploma or GED. 2+ years of experience working independently and researching/conducting investigations. 1+ years of experience in a position investigating fraud (health care fraud investigations experience preferred). Preferred Qualifications Bachelor's degree in criminal justice or related field. 2+ years of experience working in the group health business preferred, health insurance sales or sales compliance. Intermediate level knowledge of Local, State & Federal laws and regulations pertaining to health insurance (Medicare, Medicare Advantage, Medicare Part D, Medicaid, Tricare, Pharmacy, and/or commercial health insurance). Experience with Facets, or other claims processing systems. Certified Fraud Examiner preferred. Benefits & Compensation Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, and more. Salary range: $49,700 to $88,800 annually based on full-time employment. Benefits include: comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution (subject to eligibility requirements). All telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy. EEO Statement Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. 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. Drug-Free Workplace UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. #J-18808-Ljbffr