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Senior Investigator 2384260 | Houston, Texas | Remote

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Posted Yesterday
United StatesRemote$60.2K–$107.4KHealthcare/Clinical
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The UnitedHealth Group Careers website will be undergoing planned maintenance. There will be downtime on Friday, March 27th 5:00 PM Central - Saturday, March 28th 5:00 PM Central. Blogs Job seeker resources Login Bookmarked jobs ( 0 ) Career areas Life here Join our talent community Clinical › Corporate and business operations › Customer and support services › Early careers › Sales and account management › Technology and data › Physicians › Advanced practice clinicians › Pharmacy › Behavioral health › Nursing › Medical coding › Clinical support › U.S. › Ireland & UK › India › Philippines › Culture of Belonging › Employee Benefits › Blog Job seeker resources Login Bookmarked jobs ( 0 ) Career areas Clinical Physicians Advanced practice clinicians Pharmacy Behavioral health Nursing Medical coding Clinical support Corporate and business operations Administrative support Consulting Finance and business analytics Legal and compliance Marketing and communications People team Project management Customer and support services Billing Claims Customer Service Data entry Early careers Sales and account management Account management Sales Sales management Technology and data Artificial intelligence Architecture Business systems analysis Data analytics Data engineering Data science Network infrastructure Product management & development Security and risk Software engineering Life here U.S. Culture of Belonging Employee Benefits Military Fellowship Program Ireland & UK Culture of Belonging Employee Benefits India Culture of Belonging Employee Benefits Philippines Culture of Belonging Employee Benefits Join our talent community Search Jobs Open search form Keyword or job number Location Go Explore remote jobs Pursue your passion and potential Senior Investigator Houston, Texas Apply Internal apply Bookmark job Jump to Our values Job description Benefits Testimonial Awards & recognitions Related content Caring. Connecting. Growing together. With these values to guide us, our people are committed to making a meaningful difference in the lives of those we are honored to serve. Integrity Compassion Inclusion Relationships Innovation Performance Senior Investigator Requisition number: 2384260 Job category: Regulatory & Compliance Primary location: Houston, Texas Date posted: 09/10/2026 Overtime status: Exempt Travel: Yes, 25 % of the Time Share this job Facebook X LinkedIn Email 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 fieldwork to perform interviews and obtain records and/or other relevant documentation. You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Preference for those residing in EST or CST zones. Flexibility required to work EST or CST hours. Primary Responsibilities: A ssess 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 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 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 25% and valid US driver's license 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. 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. 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 Internal apply Bookmark job Benefits Our mission of helping people live healthier lives extends to our team members. Learn more about our range of benefits designed to help you live well. Life Resources and support to focus on what matters most to you, in every facet of your life. Emotional Education, tools and resources to help you reduce and manage stress, build resilience and more. Physical Health plans and other coverage to support wellness for you and your loved ones. Financial Benefits for today and to help you plan for the future, including your retirement. Learn more Previous slide The most motivating aspect of my role is to help people live healthier lives. If roles were reversed, I'd want someone I could trust to be there in the moments that matter. Orrin K. Director of Health Plan Operations – Hawaii Making a difference is not about the big things or grand gestures; it's about impacting one person at a time even the smallest way. If I know I've impacted just one person, with a smile, or a kind word, or even a helping hand, then I know I've made a difference. Amaris A. Program Integrity Manager Knowing the company supports both professional and personal growth — like furthering our education — makes me incredibly proud. Jessyca G. Senior Health Advocate The most motivating aspect of my role is to help people live healthier lives. If roles were reversed, I'd want someone I could trust to be there in the moments that matter. Orrin K. Director of Health Plan Operations – Hawaii Making a difference is not about the big things or grand gestures; it's about impacting one person at a time even the smallest way. If I know I've impacted just one person, with a smile, or a kind word, or even a helping hand, then I know I've made a difference. Amaris A. Program Integrity Manager Knowing the company supports both professional and personal growth — like furthering our education — makes me incredibly proud. Jessyca G. Senior Health Advocate The most motivating aspect of my role is to help people live healthier lives. If roles were reversed, I'd want someone I could trust to be there in the moments that matter. Orrin K. Director of Health Plan Operations – Hawaii Next slide Go to slide 1 Go to slide 2 Go to slide 3 We’re honored to be recognized for our exceptional work culture Discover our family of businesses See how we’re structured to help build a modern, high-performing health system. Learn more Explore our hiring process Learn what to expect when you pursue an opportunity with us. Learn more Committed to sustainability Take a look at all the ways we’re working for a healthier, more sustainable future. Learn more Load more Connect with us Facebook YouTube X LinkedIn Do not sell or share my personal information Social responsibility Fraudulent activity Cookie management Site map Privacy Policy Family & Medical Leave Act (PDF) Equal Employment Law Poster (PDF) SMS Terms & Conditions (PDF) Employee Polygraph Protection Act (PDF) E-Verify Participation Poster (PDF) Pay Transparency Nondiscrimination Provision (PDF) Immigrant and Employee Right to Work Poster (PDF) Health Plan Notices (PDF) County of LA Fair Chance Ordinance (PDF)

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