Hiring: Senior Investigator Pharmacy - Los Angeles County, CA Company: UnitedHealthcare Location: Los Angeles, CA Job Posted Time: 2026-09-12 10:46:16 Employment Type: Full-time Target Skills & Keywords : Microsoft Excel About the job Experience: •2+ 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 •2+ years of experience in health care policies, procedures, and documentation standards 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 with healthcare related employment •Intermediate level of proficiency with Microsoft Excel and Word •Intermediate level of knowledge in pharmacy claims processing •Demonstrated capacity to participate in legal proceedings, arbitration, and depositions at the direction of management •Reside within the greater Los Angeles County, CA area with the ability to travel up to 50% •Access to reliable transportation and valid driver's license •Specialized knowledge/training in healthcare FWA investigations •National Health Care Anti-Fraud Association (NHCAA) •Accredited Health Care Fraud Investigator (AHFI) 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!