Remote Program Integrity Manager - FWA Compliance

UnitedHealthcare; Pittsburgh (Allegheny County); On-site; USD 91,700 - 163,700; Full time

Benefits offered by this job

Benefits package

Job summary

UnitedHealthcare Community & State, part of UnitedHealth Group, seeks a Health Plan Program Integrity / Fraud, Waste and Abuse compliance consultant to join our Compliance team. This individual contributor role leads FWA policy implementation and vendor monitoring to drive improvements for the Medicaid health plan.

Responsibilities include regulatory liaison, training program delivery, and investigations support, with remote work options for Pennsylvania-based staff.

Qualifications

• 2+ years in FWA, investigations, regulatory or compliance.
• 2+ years in government, health care or managed care environment.
• Ability to translate complex concepts for diverse audiences.
• Identify root causes and drive corrective actions.
• Proficient with MS Word, Excel and PowerPoint.

Responsibilities

• Ensure internal processes related to FWA vendors are followed.
• Serve as FWA SME for federal and state regulations.
• Stay updated on current and proposed regulations and educate audiences.
• Lead FWA training and education programs across business areas.
• Gather and analyze information for FWA investigations.

Skills

MS Word

MS Excel

MS PowerPoint

English communication

Job description

UnitedHealthcare Community & State, part of UnitedHealth Group, seeks a Health Plan Program Integrity / Fraud, Waste and Abuse compliance consultant to join our Compliance team. This individual contributor role leads FWA policy implementation and vendor monitoring to drive improvements for the Medicaid health plan.

Responsibilities include regulatory liaison, training program delivery, and investigations support, with remote work options for Pennsylvania-based staff.