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Fraud/Abuse Reporting Specialist - Healthcare Data Analytics - Sacramento, CA

UnitedHealth Group

Sacramento, CA
Job Code:
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Fraud/Abuse Reporting Specialist - Healthcare Data Analytics - Sacramento, CA(Job Number:693037)

As a Fraud/Abuse Reporting Specialist, you will be empowered to support short and long term operational/strategic business activities; develop, enhance and maintain operational information and models that will have an impact on business decisions. In this role, you will have the opportunity to work directly with the California Department of Healthcare Services and other State agencies to create valuable solutions to improve the health care system. Join us! Your passion for performance can fuel your life's best work.(sm)


Our group provides support for 400 users of the largest Medicaid data warehouse. We collaborate on Business Intelligence (BI) analytic solutions, develop complex queries and data extracts, and bring BI trends, tools and developments to the State healthcare administrators and research staff. We are helping the State identify fraud and abuse within the Medi-Cal program to reduce costs and improve health care delivery.


Primary Responsibilities:

  • Provide support to end-users in identifying suspected healthcare fraud via ad hoc reports generated using data mining tools such as BusinessObjects, SQL or SAS
  • Assist end-users in retrieving, reporting, and interpreting warehouse data
  • Review ad-hoc and operational reports developed and presented by team members
  • Provide focused, onsite consultation to fraud and abuse related program areas
  • Identify BI system enhancements or improvements that increase the efficient use of the system or the retrieval, interpretation, and presentation of the data from the warehouse
  • Provide customer with a functional analysis of system changes
  • Analyze, review, forecast, and trend complex healthcare data
  • Present analysis and interpretation for operational and business review and planning
  • Develop and deliver technical and subject-matter papers, presentations and training courses

Job Business Analysis
Primary Location US-CA-Sacramento
Other Location 
Organization Optum Data Management
Schedule Full-time
Number of Openings 1
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UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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