Top 47 Investigations Jobs in Albuquerque, Nm

Senior Investigator
UnitedHealthcare —Albuquerque, NM
- $60,200 - $107,400 a year
- Full-time
- Remote
- Microsoft Word
- Up to 50% travel
- Pass drug screening
- AD&D insurance
- Employee stock purchase plan
Investigator (MDC)
Bernalillo County —Albuquerque, NM
- $25.97 - $41.04 an hour
- Full-time
- Mid-level
- Driver's License
- Business Administration
1d
Investigator 2 (3277)
New Mexico State Personnel Office —Albuquerque, NM
- $54,870.40 - $98,612.80 a year
- Overtime
- Background check
- Mid-level
- Driver's License
- Disability insurance
- Health insurance
9d
Resolution & Investigation Coordinator (NMDOJ/OCA #10118956+)
State of New Mexico —Albuquerque, NM
- $27.37 - $41.06 an hour
- Full-time
- Mid-level
- Office
- Driver's License
Intake & Investigative Manager (NMDOJ/OCA #10118955)
State of New Mexico —Albuquerque, NM
- $36.43 - $54.65 an hour
- Full-time
- Office
- 8 years
- Driver's License
PSID Investigation Analyst I (DHS)
ADC LTD NM —Albuquerque, NM
- $22.84 - $23.81 an hour
- 8 hour shift
- Background check
- Customer service
- Pass drug screening
Quick Apply
Corporate Security Manager
PNM (PNMR) —Albuquerque, NM
- $110,004 - $187,007 a year
- Full-time
- 7 years
- Ability to walk for extended periods
- Word processing
CPS Investigation Case Worker (CYFD/PSD #10119027+)
State of New Mexico —Albuquerque, NM
- $27.37 - $41.06 an hour
- Full-time
- Mid-level
- Office
- Driver's License
3d
Food Compliance Officer (ECECD #10110475)
State of New Mexico —Albuquerque, NM
- $22.62 - $33.93 an hour
- Full-time
- 18 years or older
- Mid-level
- Office
7d
Director, Compliance
HCT Healthcare Transformation —Albuquerque, NM
- $172,000 - $182,000 a year
- Bachelor's degree
- Senior level
4d
Deputy Medical Investigator
University of New Mexico —Albuquerque, NM
- $19.76 - $26.85 an hour
- Extended hours
- Bilingual
- Background check
- Current TB test
- Health insurance
- Dental insurance
Healthcare Surveyor / IMB Investigator (HCA/DHI #13106+)
State of New Mexico —Albuquerque, NM
- $27.37 - $41.06 an hour
- Full-time
- Nursing
- Mid-level
- Office
- Health insurance
3d
After Hours CPS Investigation Case Worker (CYFD/PSD #10109594+)
State of New Mexico —Albuquerque, NM
- $27.37 - $41.06 an hour
- Weekends as needed
- Mid-level
- Office
- Driver's License
Surveillance Investigator I - Entry Level
Command Investigations, LLC —Albuquerque, NM
- $20 - $25 an hour
- 8 hour shift
- Microsoft Word
- Background check
- Clean driving record
- Health insurance
- Dental insurance
Quick Apply
Safety Investigations/Analysis Specialist
4ES Corporation —Albuquerque, NM
- Full-time
- Microsoft Excel
- 5 years
- Research
Quick Apply
11d
Healthcare Surveyor / IMB Investigator (HCA/DHI #41209)
State of New Mexico —Albuquerque, NM
- $27.37 - $41.06 an hour
- Full-time
- Nursing
- Adults
- Mid-level
- Health insurance
1d
As Needed Field Investigator- Albuquerque, NM
J T Becker & Co Inc —Albuquerque, NM
- Writing skills
- Mid-level
- Driver's License
- Flexible schedule
Quick Apply
State Investigator (DOT/GO/Trans Reg #4183)
State of New Mexico —Albuquerque, NM
- $27.37 - $41.06 an hour
- Full-time
- Mid-level
- Office
- Finance
3d
Contract Investigative Technician - New Mexico (Albuquerque)
ADC LTD NM —Albuquerque, NM
- Contract
- Mid-level
Quick Apply
Civil Rights Investigator and Trainer
University of New Mexico —Albuquerque, NM
- $4,277.87 - $6,009.47 a month
- Full-time
- Background check
- HIPAA
- Mid-level
- Health insurance
- Dental insurance

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investigations jobs near albuquerque, nm

Senior Investigator

UnitedHealthcare -
Albuquerque, NM

Apply Now

Job Details

Full-time
$60,200 - $107,400 a year

Benefits

AD&D insurance
Employee stock purchase plan
Paid holidays
Disability insurance
Health insurance
Dental insurance
401(k)
Tuition reimbursement
Paid time off
Employee assistance program
Vision insurance
Employee discount
Referral program
Pet insurance

Qualifications

Microsoft Word
Healthcare financial misconduct investigations
Investigations regulatory compliance
Medical law
Spreadsheets
State healthcare regulations
Investigative data analysis
Driver's License

Full Job Description

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 to start Caring. Connecting. Growing together.

The Senior Investigator is responsible for identification, investigation and prevention of healthcare fraud, waste, and abuse. The Senior Investigator will utilize claims data, applicable guidelines, and other sources of information to identify aberrant billing practices and patterns. The Senior Investigator is responsible for conducting investigations which may include field work to perform interviews and obtain records and/or other relevant documentation.

If you reside in the state of New Mexico, you will have the flexibility to telecommute* as you take on some tough challenges.

Schedule: Monday-Friday 8-4:30 CST

Primary Responsibilities:

Assess complaints of alleged misconduct received within the Company
Investigate medium to high complex cases of fraud, waste, and abuse
Detect fraudulent activity by members, providers, employees, and other parties against the Company
Develop and deploy the most effective and efficient investigative strategy for each investigation
Maintain accurate, current, and thorough case information in the Special Investigations Unit's (SIU's) case tracking system
Collect and secure documentation or evidence and prepare summaries of the findings
Participate in settlement negotiations and/or produce investigative materials in support of the latter
Collect, collate, analyze, and interpret data relating to fraud, waste, and abuse referrals
Ensure compliance of applicable federal/state regulations or contractual obligations
Report suspected fraud, waste, and abuse to appropriate federal or state government regulators
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
Communicate effectively, including written and verbal forms of communication
Develop goals and objectives, track progress and adapt to changing priorities
Must participate in legal proceedings, arbitration, and depositions at the direction of management

What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
Medical Plan options along with participation in a Health Spending Account or a Health Saving account
Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
401(k) Savings Plan, Employee Stock Purchase Plan
Education Reimbursement
Employee Discounts
Employee Assistance Program
Employee Referral Bonus Program
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

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:

Associate's degree or above
2+ years of experience in fraud, waste and abuse (FWA) investigations/audit
2+ years of experience with state/federal laws and regulations pertaining to healthcare FWA
2+ years of experience in analyzing data to identify fraud, waste and abuse trends
Intermediate level of proficiency in Microsoft Excel and Word
Ability to travel up to 50%, access to reliable transportation, and & valid US driver's license
Reside in the state of New Mexico

Preferred Qualifications:

Specialized knowledge/training in healthcare FWA investigations
Active affiliations with the National Health Care Anti-Fraud Association (NHCAA)
Accredited Health Care Fraud Investigator (AHFI)
Certified Fraud Examiner (CFE)
Certified Professional Coder (CPC)
Medical Laboratory Technician (MLT)
Statistical Analysis
All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO #GREEN

Apply Now

Refine Your Search

investigations jobs in albuquerque, nm

Senior Investigator

Investigator (MDC)

Investigator 2 (3277)

Resolution & Investigation Coordinator (NMDOJ/OCA #10118956+)

Intake & Investigative Manager (NMDOJ/OCA #10118955)

PSID Investigation Analyst I (DHS)

Corporate Security Manager

CPS Investigation Case Worker (CYFD/PSD #10119027+)

Food Compliance Officer (ECECD #10110475)

Director, Compliance

Deputy Medical Investigator

Healthcare Surveyor / IMB Investigator (HCA/DHI #13106+)

After Hours CPS Investigation Case Worker (CYFD/PSD #10109594+)

Surveillance Investigator I - Entry Level

Safety Investigations/Analysis Specialist

Healthcare Surveyor / IMB Investigator (HCA/DHI #41209)

As Needed Field Investigator- Albuquerque, NM

State Investigator (DOT/GO/Trans Reg #4183)

Contract Investigative Technician - New Mexico (Albuquerque)

Civil Rights Investigator and Trainer

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