At UnitedHealthcare, 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 better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life's best work.(sm)

As an Investigations Data Consultant, you’ll be responsible of maintaining and developing Special Investigations Unit’s (SIU’s) case tracking system. Identifying opportunities for enhancements for proper reporting of potential fraud, waste and/or abuse and working with UHC SIU Leadership to ensure the highest level of compliance. You’ll be fully invested in the outcomes and will be helping the health system work better for everyone with the support and resources of a Fortune 5 industry leader.

You’ll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Performs medium to highly complex analytical functions to prevent, detect and correct of fraud, waste and abuse
• Detect fraudulent activity by members, providers, employees, and other parties against the Company
• Develop most effective and efficient analytical strategy for each investigation
• Support and perform regulatory reporting requirements
• Performs all activities in a manner consistent with Application, Development & Reporting core principles
• Build complex SQL/SAS queries and identify potential risks of FWA
• Develop and enhance current SQL store procedures
• Develop and enhance current Tableau Dashboards
• Ensure compliance of applicable federal/state regulations or contractual obligations
• 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 workgroups or regulatory meetings
  

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:

• Bachelor’s degree or Associates degree and 2+ years of equivalent work experience
• 5+ years of data manipulation via SQL/SAS tools
• Proficient in Microsoft Office Suite
• Proficient with one or more of the following SQL, SAS, Python and VBA
• Ability to travel
  

Preferred Qualifications:

• Intermediate knowledge and experience in any of the following:
  • Statistical Analysis Software (SAS)
  • Tableau
  • Python
  • Structured Query Language (SQL 2012)
  • TOAD
  • Statistical Analysis
  • Regression Analysis
  • Linear Analysis
  • Market-basket Analysis
• Intermediate knowledge and experience in health care fraud, waste and abuse (FWA) investigations
• Intermediate knowledge and experience in state and federal regulatory FWA requirements
• General knowledge of Compliance Program policies, procedures, and documentation standards
• Proven ability to develop goals and objectives, track progress, and adapt to changing priorities
• Knowledge of Queries / Store Procedures
• General knowledge of Tableau development
• Demonstrated ability to communicate effectively, to include written and verbal forms of communication
  

Careers with UnitedHealthcare. Work with a Fortune 5 organization that’s serving millions of people as we transform health care with bold ideas. Bring your energy for driving change for the better. Help us improve health access and outcomes for everyone, as we work to advance health equity, connecting people with the care they need to feel their best. As an industry leader, our commitment to improving lives is second to none.

California, Colorado, Connecticut, Nevada, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New York, Rhode Island or Washington residents is $67,800 to $133,100. 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, you’ll find a far-reaching choice of benefits and incentives.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe 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 experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.




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.