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Senior Investigator - Remote

May 9, 2026

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.

You will enjoy the flexibility to telecommute\* 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 medium to highly 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
Communicate effectively, including written and verbal forms of communication
Develop goals and objectives, track progress and adapt to changing priorities
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
*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:
Bachelor's Degree OR Associate's Degree with 2 years of equivalent work experience with healthcare related employment
2+ years of experience in health care fraud, waste and abuse (FWA)
2+ years of experience in state or federal regulatory FWA requirements
2+ years of experience analyzing data to identify fraud, waste and abuse trends
Intermediate level of proficiency in Microsoft Excel and Word
Ability to participate in legal proceedings, arbitration, and depositions at the direction of management
Ability to travel up to 25%
Access to reliable transportation & valid US driver's license
*Preferred Qualifications:
Demonstrated intermediate level of knowledge in health care policies, procedures, and documentation standards or 2-5 years of experience
Demonstrated intermediate level of skills in developing investigative strategies or 2-5 years of experience
Specialized knowledge/training in healthcare FWA investigations
Active affiliations: 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)

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This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

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