Investigative Assistant - Fraud, Waste & Abuse (FWA)
- Employer
- UCare
- Location
- Minneapolis, Minnesota
- Posted
- Feb 17, 2023
- Closes
- Mar 22, 2023
- Ref
- 3393
- Category
- Healthcare
- Employment Status
- Full Time
Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 600,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs.
UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.
Rewards
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
www.ucare.org/careers/
EOE/AA
ABOUT UCARE
UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.
WORKING AT UCARE
Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job.
Our strong culture has established UCare as a Star Tribune Top 200 Workplace for 13 consecutive years since the awards program began. It's a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.
INVESTIGATIVE ASSISTANT - FRAUD, WASTE & ABUSE (FWA)
Work Location: Work from Home or Office for Your Day.
Position Description
As an Investigative Assistant, you will conduct various activities to support UCare's Fraud, Waste, and Abuse (FWA) prevention, detection, investigation, and correction work. This position is responsible to collect and analyze potential Fraud, Waste, and Abuse leads within the Special Investigations Unit (SIU). Additionally, you will support this work through administrative assignments including, but not limited to, assigned research and reporting, process development and documentation, and managing financials related to investigation recoveries or restitution.
• Collect potential FWA leads submitted to SIU, documenting within SIU's case management software.
• Utilize investigative techniques to gather necessary and pertinent facts to review any potential FWA allegation(s) within a lead.
• Execute sound judgement via critical thinking when developing and executing lead resolution and/or next steps for investigation, with the assistance of SIU Leadership.
• Manage and respond to requests for information or data.
• Manage and execute SIU reporting responsibilities, as assigned.
• Manage and process administrative assignments, as assigned.
• Provide investigative assistance to SIU staff on complex cases, as needed.
• Other projects and duties as assigned.
Education
Associate degree: demonstrated experience may be considered in lieu of degree.
Required Experience
Knowledge of medical terminology. Demonstrated experience using data to perform investigations, audits, or project work, including intermediate skill level with Excel.
Preferred Experience
Experience working within the health care industry. Knowledge of Medicare and Medicaid. Experience working with medical claims.
THE UCARE DIFFERENCE
The UCare difference is our people power - employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.
As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
JOB POST DATE: 2/16/2023
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 600,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs.
UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.
Rewards
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
www.ucare.org/careers/
EOE/AA
ABOUT UCARE
UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.
WORKING AT UCARE
Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job.
Our strong culture has established UCare as a Star Tribune Top 200 Workplace for 13 consecutive years since the awards program began. It's a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.
INVESTIGATIVE ASSISTANT - FRAUD, WASTE & ABUSE (FWA)
Work Location: Work from Home or Office for Your Day.
Position Description
As an Investigative Assistant, you will conduct various activities to support UCare's Fraud, Waste, and Abuse (FWA) prevention, detection, investigation, and correction work. This position is responsible to collect and analyze potential Fraud, Waste, and Abuse leads within the Special Investigations Unit (SIU). Additionally, you will support this work through administrative assignments including, but not limited to, assigned research and reporting, process development and documentation, and managing financials related to investigation recoveries or restitution.
• Collect potential FWA leads submitted to SIU, documenting within SIU's case management software.
• Utilize investigative techniques to gather necessary and pertinent facts to review any potential FWA allegation(s) within a lead.
• Execute sound judgement via critical thinking when developing and executing lead resolution and/or next steps for investigation, with the assistance of SIU Leadership.
• Manage and respond to requests for information or data.
• Manage and execute SIU reporting responsibilities, as assigned.
• Manage and process administrative assignments, as assigned.
• Provide investigative assistance to SIU staff on complex cases, as needed.
• Other projects and duties as assigned.
Education
Associate degree: demonstrated experience may be considered in lieu of degree.
Required Experience
Knowledge of medical terminology. Demonstrated experience using data to perform investigations, audits, or project work, including intermediate skill level with Excel.
Preferred Experience
Experience working within the health care industry. Knowledge of Medicare and Medicaid. Experience working with medical claims.
THE UCARE DIFFERENCE
The UCare difference is our people power - employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.
As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
JOB POST DATE: 2/16/2023
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