Senior Pharmacy FWA Investigator

UnitedHealthcare; New York (NY); Hybrid; USD 60,200 - 107,400; Full time

Benefits offered by this job

Paid Time Off

Medical plan options

401(k) savings plan

Education reimbursement

Employee discounts

Job summary

A leading health care organization is looking for a Senior Investigator Pharmacy to tackle healthcare fraud, waste, and abuse. The role includes investigating complex cases and preparing detailed reports based on findings. Candidates must have a Bachelor's or Associate's Degree with relevant experience, and knowledge of pharmacy claims processing is preferred. The position requires up to 50% travel within designated areas, with a salary range of $60,200 to $107,400 annually, along with comprehensive benefits.

Qualifications

• Bachelor's or Associate's Degree plus two years of equivalent healthcare experience.
• 2+ years experience with fraud, waste and abuse in healthcare.
• Intermediate knowledge of pharmacy claims processing.

Responsibilities

• Assess complaints of misconduct within the company.
• Investigate complex cases of fraud, waste, and abuse.
• Communicate findings to stakeholders and prepare necessary documentation.

Skills

Healthcare fraud analysis

Data interpretation

Effective communication

Investigative strategy development

Intermediate Excel

Intermediate Word

Education

Bachelor's Degree

Associate's Degree with equivalent work experience

Tools

Microsoft Excel

Microsoft Word

Job description

A leading health care organization is looking for a Senior Investigator Pharmacy to tackle healthcare fraud, waste, and abuse. The role includes investigating complex cases and preparing detailed reports based on findings. Candidates must have a Bachelor's or Associate's Degree with relevant experience, and knowledge of pharmacy claims processing is preferred. The position requires up to 50% travel within designated areas, with a salary range of $60,200 to $107,400 annually, along with comprehensive benefits.