Manager, Fraud and Waste
Humana
full-time
Posted on:
Location Type: Hybrid
Location: California • Illinois • United States
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Salary
💰 $78,400 - $107,800 per year
About the role
- lead investigations into suspected fraudulent or abusive practices involving healthcare services and related health plan activities
- operate within established guidelines and procedures, leveraging advanced technical expertise to resolve moderately complex issues
- collaborate with law enforcement agencies to coordinate investigative activities
- prepare detailed and complex investigative and audit reports
- conduct on-site audits of provider records to assess the accuracy and appropriateness of billing practices
Requirements
- Bachelor's Degree
- Previous operational leadership experience, including leading teams and investigations
- Prior healthcare fraud investigative experience
- Excellent PC skills (including MS, Excel and Access) required
- Excellent communication skills, written and verbal
- Strong organizational and project management skills
Benefits
- medical, dental and vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
investigative reportingaudit reportingbilling practices assessmentfraud investigationdata analysis
Soft Skills
leadershipcommunicationorganizational skillsproject managementcollaboration
Certifications
Bachelor's Degree