Manager, Financial Crime Services - Federal Healthcare Fraud, Waste, and Abuse
$110.7k - $218.3kDeloitte
Position Summary Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk and an evolving regulatory environment into defensible actions that strengthen, protect, and transform their organization. Join our team and use advanced data, AI, and emerging technologies with industry insights to help clients bring clarity from complexity and accelerate their path to value creation. Work You’ll Do As a Manager, Financial Crime Services, you will work with a cross disciplinary team to deploy a fraud detection accelerator for a large federal health care program. Key Responsibilities: Analyze health insurance claims data, open source, and public information to identify new and emerging fraud schemes and identify suspicious billing patterns or other activities indicative of potentially fraudulent behavior.Conduct analysis of open source and public information to identify sources of identity theft.Perform proactive referral generation based on external data, such as government furnished reports and open source information, such as social media. Develop fraud referrals for presentation to the client, law enforcement, and other government agencies. Identify public health insurance program vulnerabilities through data analytics and open-source information. The successful candidate would possess these skills: Ability to work independently and collaborate as part of a teamEffective written and verbal communication skillsMeticulous attention to detail and quality of work productAbility to build and sustain professional relationships Ability to lead projects or workstreamsAbility to manage and prioritize multiple tasks in a fast-paced and dynamic environmentStrong interpersonal skills and professional demeanor Ability to meet deadlinesAbility to mentor and provide clear guidance to others The Team Deloitte’s Government & Public Services (GPS) practice – our people, ideas, technology and outcomes – is designed for impact. Serving federal, state, & local government clients as well as public higher education institutions, our team of professionals brings fresh perspective to help clients anticipate disruption, reimagine the possible, and fulfill their mission promise. Our Enterprise Operations & Risk offering enables clients to achieve profitable growth and competitive advantage by optimizing “heart of the business” operations. Leverages deep domain expertise to extend enterprise resilience, agility and remediation. Addresses client needs which span the organization and impact strategy, operations, performance and reputation. Qualifications Required: Bachelor’s degree6+ years of experience in healthcare fraud and/or program integrity6+ years of experience supporting programs identifying and mitigating fraud, waste, or abuse. Ability to travel 5-25%, on average, based on the work you do and the clients and industries/sectors you serveMust be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future Preferred: Experience presenting to clients or other decision makers to represent and articulate ideas to various audiences (technical and non-technical)Excellent written communication skills, including experience drafting findings or referral documentationAbility to synthesize open-source and public information into actionable insightsExperience in healthcare policy, program integrity, or regulatory compliance domains The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $110,700 to $218,300. You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance. Deloitte is committed to providing reasonable accommodations for people with disabilities. If you require a reasonable accommodation to participate in the recruiting process, please direct your inquiries to the Global Call Center (GCC) at View email address on click.appcast.io. Recruiting tips From developing a stand out resume to putting your best foot forward in the interview, we want you to feel prepared and confident as you explore opportunities at Deloitte. Check out recruiting tips from Deloitte recruiters. Benefits At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits. Learn more about what working at Deloitte can mean for you. Our people and culture Our inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. It enables us to leverage different ways of thinking, ideas, and perspectives, and bring more creativity and innovation to help solve our clients' most complex challenges. This makes Deloitte one of the most rewarding places to work. Our purpose Deloitte’s purpose is to make an impact that matters for our people, clients, and communities. At Deloitte, purpose is synonymous with how we work every day. It defines who we are. Our purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. Learn more. Professional development From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to build new skills, take on leadership opportunities and connect and grow through mentorship. From on-the-job learning experiences to formal development programs, our professionals have a variety of opportunities to continue to grow throughout their career. As used in this posting, "Deloitte" means Deloitte Transactions and Business Analytics LLP, a subsidiary of Deloitte LLP. Please see for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or protected veteran status, or any other legally protected basis, in accordance with applicable law. Qualified applicants with criminal histories, including arrest or conviction records, will be considered for employment in accordance with the requirements of applicable state and local laws, including the Los Angeles County Fair Chance Ordinance for Employers, City of Los Angeles’s Fair Chance Initiative for Hiring Ordinance, San Francisco Fair Chance Ordinance, and the California Fair Chance Act. See notices of various fair chance hiring and ban-the-box laws where available. Fair Chance Hiring and Ban-the-Box Notices | Deloitte US Careers Requisition code: 373357 Job ID 373357 Risk, Compliance, and Governance | Financial Crime and FraudSame job available in 16 locations
- ...Healthcare Fraud Investigator Employment Type: Full... ...Excel. Review financial records, complex... ...evidence of fraud, waste and abuse. Review and... ...HCF training for federal, state and local... ...finance, project management, or other related... ...the requisite services in Section 3. Must...FraudFull timeWork experience placementWork at officeLocal area
- ...Intersect Group in Los Angeles seeks an experienced Manager for the Special Investigations Unit (SIU) to lead healthcare fraud investigations and supervise a team of... ...guide investigations into suspected fraud, waste, and abuse, while ensuring quality and compliance with...Fraud
- ...candidates for GS-11/GS-12 levels. Candidates must have specialized experience in investigations or financial examinations and knowledge of laws related to health care fraud, contracting fraud, or similar areas. Strong interview and reporting skills are required to...FraudWork at office
- ...life sciences companies, and healthcare investors. Location Los... ...Navigating and advising clients on federal and state healthcare regulations, including fraud and abuse laws, the corporate practice... ...Industries ~ IT Services and IT Consulting #J-188...FraudFull time
$250k - $350k
...About the job Healthcare Litigation Attorney Annual Salary Range... ...False Claims Act litigation, federal and state investigations,... ...declarations, and memoranda. Manage projects, litigation... ...federal and California healthcare fraud and abuse laws. Requirements At...FraudTemporary workRemote work$213.1k - $308.3k
...The Job The Utilization Management (UM) Physician Medical Director... ..., and applicable state and federal turnaround-time... ...care concerns, or potential fraud, waste, and abuse, escalating as appropriate.... ...software. Sound understanding of healthcare regulatory, compliance, and...FraudFor contractorsWork at officeLocal areaRemote workRelocation$88.85k
...Utilization Management (UM) Claims Review Nurse RN IISalary Range... ...of medical claims to ensure services were medically necessary,... ...and monitors for potential fraud, waste, and abuse (FWA). The UM Claims Review... ...support compliance with state, federal, and accreditation...Fraud$7.52k - $10.14k
...and diverse public services, including law... ...safeguarding the rights of crime victims and the... ..., and consumer fraud. You may also work... ...local, state, and federal law enforcement agencies... ...Attorney, financial transactions) in order... ...history Substance abuse Driving under the...FraudFull timeSecond jobWork at officeLocal areaTrial period$75 - $135 per hour
...Now Hiring – Of Counsel Attorney | Federal Criminal & Healthcare Fraud Defense (California) Watson & Associates... ...court proceedings (as needed) and manage client communications Analyze... ...Whistleblower/qui tam defense White-collar crime and healthcare fraud cases...FraudHourly payContract workPart timeWork at officeImmediate startRemote workFlexible hours$50.18 - $77.91 per hour
...He will direct, delegate and manage the care delivered by... ...families concerns and access to healthcare team). Collaborates with the... ...to: JCAHO, OSHA, State and Federal requirements. Actively participates... ...polices regarding Fraud and Abuse, Conflict of Interest and the...FraudFlexible hoursShift work- ...accordance with current federal, state, and local... ...of Nursing Services in directing the day... ...suspected incidents of fraud to the... ...OSHA, TB, HIPAA, Abuse Prevention, Safety... ...efficient manner to avoid waste. • Ensure that appropriate... ...of and management of the nursing staff...FraudTraineeshipWork at officeLocal areaShift workWeekend work
- ...operational impact of new or revised federal policies and laws.Plan, direct, and conduct... ...functions and processes to resolve management issues and support long-range... ...initiatives across the agency to detect fraud, waste, and abuse, and establish predication for criminal...Fraud
- ...bringing life-changing resources and health services directly into our communities through... ...policies designated by Virtua Health, federal and state regulations. Complies with... ...local laws and regulations including fraud, waste and abuse. Adheres to both the spirit and letter...FraudDaily paid16 hoursPart timeLocal areaRemote workShift workDay shift
$73.15k - $129.49k
...seeking an Associate, Financial Crimes to join our Advisory Services practice.... ...leaders (BSA/AML, Fraud, and Sanctions) in... ...compliance excellenceAid management in identifying and... ...with all applicable federal, state, and local laws... ...violence or sexual abuse or any other legally...FraudH1bWork at officeLocal area$64k - $80k
Patient Financial Services Supervisor #2976 United States This is a remote... ...We are counting on you to manage multiple projects using your... ...Associate or bachelor's degree in healthcare administration, business,... ...administrative costs for federal government agencies, payers,...Remote jobFull timeTemporary workWork at officeMonday to Friday- ...provider of in-home dialysis services Industry Hospital &... ...across a multi-site, multi-state healthcare organization with physician... ...arrangements; healthcare fraud and abuse laws; Medicare and Medicaid;... ...audits and investigations, managing regulatory responses, and developing...Fraud
- ...Deputy General Counsel, Healthcare About the Company Ambitious incubation firm specializing... .... The Deputy General Counsel will also manage and develop other lawyers and help... ..., health data use, and healthcare fraud and abuse rules. Strong independent judgment, team...Fraud
$220k - $310k
Vivo HealthStaff is recruiting for a Healthcare Associate Attorney for a nationally recognized law firm. This is a full-time permanent... ...Medicare/Medicaid enrollment and reimbursement Fraud and abuse compliance (Stark Law, Anti-Kickback, CMP) HIPAA privacy...FraudPermanent employmentFull timeWork at officeMonday to Friday- CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government... ...investigations. The candidate will review financial records and regulatory documents,... ...referrals for HCF investigations. Strong Excel skills and U.S. #J-18808-Ljbffr CGS FederalFraud
$41 - $57 per hour
...-related nursing services in an outpatient... ...assessment, time management, and communication... ...comply with state and federal affirmative... ...includes a 401k match, healthcare coverage and a... ...of Recruitment Fraud DaVita will... ...payment or personal financial information at...FraudMinimum wageStart working today- ...accordance with current federal, state, and local... ...the Director of Nursing Services, to ensure that our medical... ...e.g., OSHA, TB, HIPAA, Abuse Prevention, Safety, Infection... ...or known incidence of fraud relative to false... ...respond to questions from managers and employees....FraudWork at officeLocal area
- ...the overall clinical management of the HPMC patient, including... ...outpatient clinic services as assigned.STANDARD... ...to such areas as abuse. antitrust, employment... ...discrimination, environmental fraud, false claims,... ...with all members of the healthcare team, patients, and their...FraudFull timeFor contractorsWork experience placementImmediate startFlexible hoursAfternoon shift
- ...investigations and/or financial examinations as... ..., local, and/or federal laws or... ...regarding health care fraud, contracting fraud... ...level in Federal service. Specialized Experience... ...of public healthcare programs, the statutory... ...identify fraud, waste, and abuse within such...FraudWork at officeLocal area
$41.86k - $127.46k
...enforcement organizations and the largest federal law enforcement agency within the... ...exemplify the core values of Vigilance, Service to Country and Integrity. As a Customs... ...documents or goods for criminal activity, fraud, and/or illegal operations. Utilizing...FraudContract workWork at officeLocal area$41 - $56 per hour
...Monitor patients, manage treatment plans, and respond... ...comply with state and federal affirmative action... ...includes a 401k match, healthcare coverage and a broad range... ...Beware of Recruitment Fraud DaVita will never... ...payment or personal financial information at any...FraudMinimum wageLocal areaFlexible hoursDay shiftAfternoon shift- ...opening for a Claims Team Manager to lead a Workers... ...what extraordinary claim service looks like and empowers... ...inventory management, financial and quality compliance... ...environment, litigation and fraud awareness. Ability to... ...basis prohibited by federal, state or local law. Fair...FraudWork at officeLocal areaImmediate start
$41 - $57 per hour
...workplace and comply with state and federal affirmative action... ...which includes a 401k match, healthcare coverage and a broad range of... ...information. Beware of Recruitment Fraud DaVita will never ask for payment or personal financial information at any point in the...FraudMinimum wageShift work- ...exceptional customer service in a safe and clean... ...with the Pharmacy Manager. Engage the... ...Follow all state and federal laws regarding annual... ...disposal of hazardous waste drugs. Work to prevent... ...robbery, theft, or fraud. Support... ...Fraud, Waste, and Abuse (Medicare), and DEA...FraudContract workSeasonal workLocal areaShift work
$42 - $58 per hour
...Monitor patients, manage treatment plans, and respond... ...comply with state and federal affirmative action... ...includes a 401k match, healthcare coverage and a broad range... ...Beware of Recruitment Fraud DaVita will never... ...payment or personal financial information at any...FraudMinimum wageFull timeFlexible hoursShift workDay shiftAfternoon shift3 days per week$85k - $110k
...Blue Venture Fund, and Healthcare Foundry. Be cautious of recruitment fraud, and always confirm that... ...to address gaps in services, such as Palliative Care... ...developing medication management strategies. Comfortably... ...characteristic protected by federal, state or local laws....FraudFull timeWork experience placementWork at officeLocal areaImmediate startRemote workMonday to FridayShift work
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