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Program Integrity Clinical Compliance Auditor

Optum • Boston, MA, US • published 2026-09-29 02:55:16.025641

Description

*This position is Remote in the state of Massachusetts. You will have the flexibility to work remotely\* as you take on some tough challenges.* **Optum Insight** is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start **Caring. Connecting. Growing together.** The **Sr. Recovery Resolution Analyst** will be responsible for performing compliance reviews of medical and administrative documentation to identify instances of healthcare fraud and/or wasteful and abusive conduct by health care providers who submit claims for payment. This position will utilize information from claims data analysis, plan members, the medical community, law enforcement, employee conduct, and confidential investigations in order to document relevant findings. The Sr. Recovery Resolution Analyst will conduct site visits and desk audits of provider...

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