Hiring: Senior Investigator - Michigan Company: UnitedHealthcare Location: Southfield, MI Job Posted Time: 2026-09-10 10:46:16 Employment Type: Full-time Target Skills & Keywords : Microsoft Excel About the job Experience: •2-5 years of experience •2+ years of equivalent work experience and healthcare related employment •2+ years of experience in health care fraud, waste and abuse investigations/audits (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 Required Skills: •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 Qualifications: •Bachelor's Degree or Associate's Degree with 2+ years of equivalent work experience and healthcare related employment •Intermediate level of proficiency in Microsoft Excel and Word •Demonstrated capacity to travel locally (in-state) up to 25% of the time, as needed •Access to reliable transportation & valid US driver's license •Specialized knowledge/training in healthcare FWA investigations •National Health Care Anti-Fraud Association (NHCAA) •Accredited Health Care Fraud Investigator (AHFI) •Demonstrated an 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 •All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Compensation: •$60,200 - $107,400 / year •Flexible work environment (work from home / hybrid options) •Competitive benefits and rewards package •Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!