Humana is hiring: Manager, Fraud and Waste in Chicago

Overview

Join to apply for the Manager, Fraud and Waste role at Humana.

This range is provided by Humana. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$78,400.00/yr - $107,800.00/yr

Responsibilities

• The Special Investigations Unit Manager leads and monitors investigations of allegations of fraudulent and abusive practices.
• Leads and coordinates investigations within defined guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems.
• Coordinates investigations with law enforcement authorities as needed.
• Leads investigators in assembling evidence and documentation to support adjudication, where appropriate.
• Monitors investigations to ensure appropriateness of billing practices using investigational tools.
• Prepares complex investigative and audit reports.
• Determines resources, approach, and tactical operations for projects within own department; collaborates across departments and conducts area briefings.

What Humana Offers

Remote opportunity available. Humana values associate engagement and well-being, with opportunities for professional development and continued education.

Work Style & Requirements

• WORK STYLE: Work at home/remote with 15-20% travel required
• WORK HOURS: Regular business hours in EST (8 hours per day, 5 days per week, Monday–Friday)
• Travel: Occasional travel to Humana offices for training or meetings may be required
• Required Qualifications – What It Takes To Succeed

• Bachelor's Degree
• Minimum of 3 years health insurance claims or Medicare experience
• Minimum 3 years of experience with Fraud, Waste, and Abuse in a Managed Care or government setting
• Minimum 3 years of proven leadership experience directly managing a team
• Proven knowledge of Medicare regulations
• Excellent PC skills (MS Excel, Access, PowerPoint)
• Excellent written and verbal communication skills
• Strong organizational and project management skills
• Strong analytical skills
• Core business hours align to Eastern Standard Time (EST)
• Able to analyze large amounts of data
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Certifications (BA, MBA, J.D., MSN, Clinical Certifications, CPC, CCS, CFE, AHFI)
• Understanding of healthcare industry, claims processing and internal investigative process development
• Experience in a corporate environment and understanding of business operations

Additional Information

• Benefits starting day 1 of employment
• Competitive 401k match
• Generous Paid Time Off accrual
• Tuition Reimbursement
• Parent Leave
• Well-being perks

Work-At-Home Requirements

• Must have ability to provide a high-speed internet connection for a home office
• A minimum standard speed of 25 Mbps down / 10 Mbps up is preferred
• Satellite and Wireless Internet service is not allowed for this role
• A dedicated space free from interruptions to protect member PHI / HIPAA information

Interview Format

As part of the hiring process, Humana may use Modern Hire, a third-party interviewing technology. Selected candidates may participate in pre-recorded voice interviews and/or SMS text interviews, each designed to assess fit and readiness for the role.

Humana may support virtual/homerooting interviewing to align with CDC recommendations. A temporary work-at-home period may be required. The Talent Acquisition representative will advise on the latest health and safety guidelines.

Schedule & Pay

Scheduled Weekly Hours: 40

Pay Range: $78,400 - $107,800 per year. This job is eligible for a bonus incentive plan based on company and/or individual performance.

Benefits

Humana provides competitive benefits to support whole-person well-being, including medical, dental, and vision coverage; a 401(k) plan; paid time off; holidays; parental and caregiver leave; disability coverage; life insurance; and other opportunities.

Equal Opportunity Employer

Humana does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or veteran status. Humana complies with applicable equal opportunity laws and regulations.

Application Deadline: 10-09-2025

Location-specific notes, referrals, and related roles may be listed elsewhere on the site.