Join UnitedHealthcare and Make a Difference
At UnitedHealthcare, we are dedicated to simplifying the health care experience, fostering healthier communities, and breaking down barriers to quality care. Your work with us will impact the lives of millions, creating a positive change. Join us in building the health care system of tomorrow—more responsive, affordable, and equitable. Ready to make a difference? Join us and start doing your life’s best work.(sm)
Opportunity: Health Plan Program Integrity / Fraud, Waste and Abuse Compliance Consultant
UnitedHealthcare Community & State, part of the UnitedHealth Group family of companies, is seeking an experienced Health Plan Program Integrity / Fraud, Waste and Abuse compliance consultant to join our dynamic Compliance team. As the Program Integrity Manager, you will be responsible for addressing fraud, waste, and abuse issues and conducting specific research to implement best practices and policies for the District of Columbia Medicaid health plan.
This position must reside within the District of Columbia proper. You will work in the office as needed and have the flexibility to work from home the rest of the time.
Responsibilities:
- Ensure execution of internal processes, especially related to intersegment responsibilities, for fraud, waste, and abuse instances
- Act as a subject matter expert for Federal and local FWA regulations, leading policy implementation
- Keep abreast of current, proposed, and new federal and state regulations/guidelines
- Coordinate and support implementation of FWA training and educational programs
- Oversee and ensure all required FWA regulatory reporting meets expectations
Required Qualifications:
- 2+ years of experience in a FWA, investigations, regulatory, compliance, or related role
- Experience in government, health care, managed care, insurance, or related environment
- Intermediate or higher proficiency using MS Word, MS Excel, and MS PowerPoint
- Ability to perform this role in an office setting or other company location in the D.C. metro area, as necessary
Preferred Qualifications:
- Bachelor’s degree
- Experience auditing medical billing and coding
- Demonstrated ability to manage multiple projects and relationships
- Proven excellent written and verbal English communication skills
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.
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. Our commitment to improving lives is second to none.
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Mission: At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We are committed to mitigating our impact on the environment and delivering equitable care that addresses health disparities and improves health outcomes—an enterprise priority reflected in our mission.
Diversity: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer. 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.
Apply Now