What are the responsibilities and job description for the Compliance Data Consultant - Remote position at UnitedHealth Group?
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 and start doing your life's best work.(sm)
As an Compliance Data Consultant, you’ll review data, look for patterns of potential fraud, waste and/or abuse and interact with the Special Investigations Unit (“SIU”) to complete investigations. You’ll be fully invested in the outcomes and will be helping the health system work better for everyone with the support and resources of a Fortune 5 industry leader.
You’ll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Establish, mandate and implement standard policies, procedures and best practices regarding UnitedHealthcare Investigations’ claim sampling and extrapolation methodologies and other tasks as delineated by UnitedHealthcare Investigations’ Leadership
Support and perform the collection of data for investigation needs, identify investigative data universe, perform statistically valid random sampling, coordinate and develop reports, projects, using well established knowledge of health care related data manipulation tools
Predict and detect emerging health care fraud trends and develop innovative solutions to identify them
Conduct state and federal legal research and monitor changes in requirements to mitigate risks and achieve compliance
Develop compliance communications and drive problem resolution for a business segment across UnitedHealth Group
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:
Bachelor's degree in Mathematics, Statistics and/or areas of related study
5 years of experience working in a government, legal, health care, managed care and/or health insurance environment in a regulatory, privacy, compliance, or investigation role
Experience communicating complex information via phone conversations and emails to non-technical clients, external customers, internal customers, and executives
Experience interacting & collaborating with a variety of stakeholders (other team members, internal customers, and executives)
Intermediate or better proficiency with MS Word, MS Outlook, MS Access
Advance proficiency with MS Excel, SQL, VBA, Sampling Tools such as RAT STATS
Preferred Qualifications:
Master's degree or Ph.D in Mathematics, Statistics and/or areas of related study
Experience working with Medicare, Medicare Advantage, Medicare Part D, Medicaid and/or Tricare regulations
Familiarity with data manipulation tools such as Python, SAS, and Tableau
Careers with UnitedHealthcare. Work with a Fortune 5 organization that’s serving millions of people as we transform health care with bold ideas. Bring your energy for driving change for the better. Help us improve health access and outcomes for everyone, as we work to advance health equity, connecting people with the care they need to feel their best. As an industry leader, our commitment to improving lives is second to none.
California, Colorado, Connecticut, Nevada, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New York, Rhode Island or Washington residents is $85,000 to $167,300. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
•All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
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.
