Senior Investigator Pharmacy - New Jersey, New York
UnitedHealthcareHighlight
Summary
About the Role
About You
- Bachelor's Degree OR Associate's Degree plus two years of equivalent work experience with healthcare related employment.
- 2+ years of experience in healthcare, fraud, waste and abuse (FWA).
- 2+ years of experience in state or federal regulatory FWA requirements.
- 2+ years of experience in analyzing data to identify fraud, waste and abuse trends.
- Intermediate level of experience in Microsoft Excel and Word.
- Intermediate level of knowledge in pharmacy claims processing.
- Must have a valid driver's license.
- Reside in NY or NJ and be willing and able to travel up to 50% within PA, NY, and NJ.
- 2+ years of experience in health care policies, procedures, and documentation standards.
- 2+ years of experience in developing investigative strategies.
- Specialized knowledge/training in healthcare FWA investigations.
- Active affiliations with National Health Care Anti-Fraud Association (NHCAA), Accredited Health Care Fraud Investigator (AHFI), Certified Fraud Examiner (CFE), or License and/or Certified Pharmacy Technician (CPhT).
- Operational experience with a pharmacy and/or pharmacy benefits manager (PBM).
Benefits
- 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.).
When it comes to your health, everything matters. That’s why UnitedHealthcare is helping people live healthier lives and making the health system work better for everyone. Our health plans are there for you in moments big and small, delivering a simple experience, affordable coverage, and supportive care. At UnitedHealthcare, part of the UnitedHealth Group family of businesses, we are working to create a system that is connected, aligned and more affordable for all involved; one that delivers high quality care, responsive to the needs of each person and the communities in which they live. With connections to more than 1.3 million physicians and care professionals and 6,500 hospitals and care facilities across the globe, we can collaborate in new ways to improve patient care while providing customizable and comprehensive solutions in any marketplace, anywhere. Our Values Integrity: Honor commitments. Never compromise ethics. Compassion: Walk in the shoes of the people we serve and those with whom we work. Relationships: Build trust through collaboration. Innovation: Invent the future. Learn from the past. Performance: Demonstrate excellence in everything we do. For more information about UnitedHealthcare, click here: https://www.uhc.com/ For information about careers at UnitedHealthcare, click here: https://www.workatuhc.com