Top 95 Fraud waste abuse Jobs in Texas

Investigator
UnitedHealthcare —Houston, TX
- $49,700 - $88,800 a year
- Full-time
- Remote
- Microsoft Word
- Pass drug screening
- Mid-level
4d
SIU Investigator
Centene —Texas
- $56,200 - $101,000 a year
- Full-time
- Remote
- Mid-level
- Fair chance
- 1 year
- Paid holidays
- Health insurance
Senior Investigator, Special Investigations Unit (Aetna SIU)
CVS Health —Texas
- $46,988 - $112,200 a year
- Full-time
- Remote
- Research
- Mid-level
- 3 years
- Health insurance
- Dental insurance
Medicaid Caseworker - Remote US
Gainwell Technologies —Texas
- $26,500 - $37,800 a year
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Data analysis skills
- Travel reimbursement
- Profit sharing
3d
Auditor/Investigator II
Qlarant —Texas
- $57,512 - $85,839 a year
- Full-time
- Remote
- Mid-level
- Analysis skills
- Bachelor's degree
Quick Apply
QA & Risk - Investigations Administrator
Houston-Galveston Area Council —Houston, TX
- $90,000 - $105,000 a year
- Full-time
- Management
- 5 years
- Writing skills
QA & Risk - Lead Investigator
Houston-Galveston Area Council —Houston, TX
- $75,000 - $90,000 a year
- Full-time
- Writing skills
- Mid-level
- 3 years
Investigator, Special Investigations Unit (Aetna SIU)
CVS Health —Austin, TX
- $43,888 - $93,574 a year
- Full-time
- Microsoft Word
- Spanish
- Microsoft Excel
- Health insurance
- Dental insurance
Audit/Investigation Coordinator II
Qlarant —Texas
- $17 - $23 an hour
- Full-time
- Remote
- Mid-level
- High school diploma or GED
Quick Apply
2d
Independent Medical Courier Contractor (Houston, TX)
National Courier Express —Houston, TX
- $150 - $400 a day
- Contract
- Background check
- Clean driving record
- DOT physical examination
- Health insurance
- Flexible schedule
4d
Independent Medical Courier Contractor (Dallas, TX)
National Courier Express —Irving, TX
- $150 - $400 a day
- Contract
- Background check
- Clean driving record
- DOT physical examination
- Health insurance
- Flexible schedule
4d
QA & Risk - Investigator
Houston-Galveston Area Council —Houston, TX
- $60,000 - $75,000 a year
- Full-time
- Mid-level
- Finance
- Driver's License
Principal Investigator Pharmacy - Dallas and Houston, TX
UnitedHealthcare —Houston, TX
- $72,800 - $130,000 a year
- Full-time
- Remote
- Microsoft Word
- Up to 50% travel
- Pass drug screening
Compliance Auditor
Prism Health North Texas —Dallas, TX
- Full-time
- Nursing
- HIPAA
- Mid-level
Quick Apply
Associate Auditor
Health & Human Services Comm —Austin, TX
- $4,523.16 - $5,500.00 a month
- Multiple hires
- CPA
- Mid-level
- Office
- Health insurance
- Opportunities for advancement
Quick Apply
Healthcare Compliance Investigations Manager
NorthStar Anesthesia —Irving, TX
- Full-time
- Hybrid work
- Microsoft Excel
- HIPAA
- Mid-level
11d
Wallet Technical Fraud Analyst Manager - Strategic Data Solutions
Apple —Austin, TX
- Computer Science
- Analysis skills
- Continuous improvement
Pharmacy Billing Coordinator
Senior Solutions Pharmacy —Round Rock, TX
- $20 - $22 an hour
- Full-time
- Background check
- Management
- Customer service
- Health insurance
- Dental insurance
Quick Apply
Investigator - Network Services - Full Time
CoventBridge Group —El Paso, TX
- $25 - $28 an hour
- Weekends as needed
- Background check
- Military
- Computer literacy
- Paid training
- Fuel card
11d
Director of Compliance & Privacy
Prism Health North Texas —Dallas, TX
- Full-time
- HIPAA
- 3 years
- Bachelor's degree
Quick Apply

I want to receive the latest job alert for fraud waste abuse in texas

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Investigator

UnitedHealthcare -
Houston, TX

Apply Now

Job Details

Full-time
$49,700 - $88,800 a year
4 days ago

Qualifications

Microsoft Word
Healthcare financial misconduct investigations
Investigations regulatory compliance
Medical law
Spreadsheets
State healthcare regulations
Investigative data analysis
Healthcare billing investigations
Investigating compliance violations
Associate's degree

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

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

Primary Responsibilities :

Assess complaints of alleged misconduct received within the Company
Investigate low to medium 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

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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
1+ years of experience in health care fraud, waste and abuse (FWA) investigations/audit
Basic level of knowledge/training in healthcare FWA investigations
Basic level of knowledge with state/federal laws and regulations pertaining to healthcare FWA
Basic level of knowledge in analyzing data to identify fraud, waste and abuse trends
Intermediate level of proficiency in Microsoft Excel and Word
Ability to travel up to 25%

Preferred Qualifications:

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)
Certified Pharmacy Technician (CPhT)
Medical Laboratory Technician (MLT)
Statistical Analysis
All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

For more information on our Internal Job Posting Policy, click here.

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 $49,700 to $88,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.

#RPO, #GREEN

Apply Now

Refine Your Search

fraud waste abuse jobs in texas

Investigator

SIU Investigator

Senior Investigator, Special Investigations Unit (Aetna SIU)

Medicaid Caseworker - Remote US

Auditor/Investigator II

QA & Risk - Investigations Administrator

QA & Risk - Lead Investigator

Investigator, Special Investigations Unit (Aetna SIU)

Audit/Investigation Coordinator II

Independent Medical Courier Contractor (Houston, TX)

Independent Medical Courier Contractor (Dallas, TX)

QA & Risk - Investigator

Principal Investigator Pharmacy - Dallas and Houston, TX

Compliance Auditor

Associate Auditor

Healthcare Compliance Investigations Manager

Wallet Technical Fraud Analyst Manager - Strategic Data Solutions

Pharmacy Billing Coordinator

Investigator - Network Services - Full Time

Director of Compliance & Privacy

I want to receive the latest job alert for fraud waste abuse in texas

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected