Senior Consultant, Financial Crime and Fraud - Federal Healthcare Fraud, Waste, and Abuse
$95.6k - $188.4kDeloitte
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 DoAs a Senior Consultant, Financial Crime and Fraud, 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 provide clear guidance to others The TeamDeloitte’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.QualificationsRequired: Bachelor’s degree3+ years of experience in healthcare fraud and/or program integrity3+ 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 futurePreferred: 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 $95,600 to $188,400.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: 369142 Job ID 369142 Risk, Compliance, and Governance | Financial Crime and FraudSame job available in 16 locations
- Leading complex fraud investigations in healthcare billing, coding, and claims, the full-time remote Senior Fraud Investigator will analyze large data sets to identify patterns... ...data sets to detect potential fraud, waste, and abuse in healthcare billing and claims Prepare...SeniorFraudFull timeRemote work
$194k - $235k
...that lacks personalization, behavioral healthcare can leave people feeling unseen and unsupported... ...and bias laws, AKS, FCA and other fraud and abuse laws Partner closely with Product... ...Strong interest and ideally experience with federal and state healthcare privacy...SeniorFraudFull timeFixed term contractWork at officeLocal area$121.5k - $140k
...role and our mission. Reporting to the Senior Director of Clinical Quality and... ...NCQA). Serve as a strategic leader in Fraud, Waste, and Abuse (FWA) prevention initiatives. Lead... ...clinical operations, provider operations, healthcare operations, or strategic program...SeniorFraudWorldwideSleeping nightsShift work$250k - $305k
..., a rapidly growing, mission-driven AI healthcare technology company, has exclusively retained... ...Search to assist in its search for a Senior Counsel, Commercial. Reporting directly... ...issues, including HIPAA/HITECH and fraud and abuse laws, or a strong interest in developing...SeniorFraudContract workWork at officeFlexible hours- ...A healthcare company in New York is seeking a Fraud Investigator to conduct in-depth investigations of reported fraud. Responsibilities include mentoring other investigators, investigating Medicaid fraud cases, and maintaining relationships with law enforcement. Candidates...SeniorFraud
- ...Senior Presales Consultant, Financial Services Job Description: Our client is currently seeking a dynamic... ...deliver the business benefit of financial crime-detection solutions. Provide key... ...Preferred: Detailed knowledge of fraud detection or Anti-Money Laundering industry...SeniorFraud
$46.99k - $112.2k
...Position Summary The Senior Investigator, Aetna Special... ...or suspected acts of healthcare fraud and abuse. This position will... ...Collaborate with federal, state, and local law... ...working health care fraud, waste and abuse... ...physical, emotional, and financial well‑being of colleagues...SeniorFraudHourly payFull timeTemporary workWork at officeLocal area- ...CVS Health is seeking a Senior Investigator for the Aetna Special Investigations Unit. The role focuses on complex national healthcare fraud investigations across multiple lines of business, including Medicaid-related matters. You will conduct research, perform data mining...SeniorFraud
- ...As a Senior Data Engineer at Regard, you will own the design, development... ...is to bring world-class healthcare to everyone. Our technology... ...protected by applicable federal, state or local laws. We celebrate... ...process. Recruitment Fraud Notice Regard only conducts...SeniorFraudWork at officeLocal areaHome officeVisa sponsorshipRelocation package
$155k - $175k
...rewiring a fundamentally broken healthcare system. By connecting large... ...by up to 45% and eliminates waste For Providers (Supply): Ability... ...to measuring impact Build financial models to size opportunities,... ...yourself against recruitment fraud, please note that Carrum...SeniorFraudSummer workLocal areaRemote workFlexible hours$185k - $205k
...We are looking for a Senior Technical Product Manager to lead our... ...mission is to bring world-class healthcare to everyone. Our technology... ...protected by applicable federal, state or local laws. We celebrate... ...process. Recruitment Fraud Notice Regard only conducts...SeniorFraudFull timeWork at officeLocal areaHome officeVisa sponsorshipRelocation package3 days per week$220k - $245k
...mission to transform the U.S. healthcare system — and we’re the only... ...We are seeking an exceptional Senior Data Engineer with a high sense... ..., build, and evangelize a federated data validation frameworks to... ...Teladoc Health and more. Fraud and Security Notice: Please...SeniorFraudFull timeWork at officeFlexible hours3 days per week$182.75k - $278.5k
...this by building a new mental healthcare system everyone can access.... ...therapist that meets their needs Financial Integrity: Work on the ledger... ...that great engineering is wasted if you can't bring people along... ...phishing and recruitment fraud, please note that Headway only...SeniorFraudFlexible hoursShift work$182.75k - $278.5k
Headway's Mission To Change Mental Healthcare One in four people in the US have a treatable mental... .... You know that great engineering is wasted if you can't bring people along. Our... ...yourself against phishing and recruitment fraud, please note that Headway only accepts applications...SeniorFraudFlexible hoursShift work- Goldman Sachs is seeking a senior member of Financial Crime Compliance to lead digital assets risk management and governance. You will work across... ...requires extensive experience in AML/CTF, sanctions, and fraud risk management, with a focus on evolving regulatory expectations...SeniorFraud
$71.5k - $120k
SENIOR LITIGATION COUNSEL Job No: 532907 Work Type... ...Division / Health Care Fraud & Abuse Section (HCFA) is... ...to the nature of the crimes, this position will have... ...Section receives an annual federal grant to cover 75% of... .... Advises and consults with LE on case development...SeniorFraudFull timeTemporary workWork at officeImmediate startRemote work2 days per week- ...Industry: Healthcare / Health Services - Pharmacy Job Category:... ...stay current with HIPAA and Frauds Waste and Abuse credentialing Comply with all... ...are compliant with Federal, State and Local laws regulated... ...performance evaluations and advising Senior Management of any...FraudFull timeLocal areaRelocation packageMonday to Friday
$123.88k - $201.29k
...Business Audit Job Description The Senior Audit Group Manager leads and... ...of the portfolio and financials, with deep industry, external... ...Encouraged): CIA, CFE (Certified Fraud Examiner) CAMS (Certified... ...protected under applicable federal, state, or local law. If you...SeniorFraudWork at officeLocal areaWork from homeFlexible hours- ...Litigation Support CGS is seeking a Healthcare Fraud Investigator to provide... ...as Microsoft Excel Review financial records, complex legal and... ...for evidence of fraud, waste and abuse Review and evaluate referrals... ...in HCF training for federal, state and local agencies,...FraudFull timeWork experience placementWork at officeLocal area
- ..., and techniques to assess and manage financial, operational, and reputational risks in... ...of Strategy & Operations, the Senior Policy Analyst will work directly with... ...through a dynamic structure that prevents fraud, waste, and abuse and fosters compliance with legal requirements...SeniorFraudContract work
$150k - $175k
Senior Healthcare Broker- Risk Management 1140 Avenue of the Americas 8th... ...why EPIC Insurance Brokers & Consultants has become one of the fastest... ...Insurance, Identity Theft & Fraud Protection Coverage, Legal... ...complete this form? We are a federal contractor or subcontractor....SeniorFraudHourly payContract workFor contractorsFor subcontractorWork at officeLocal area3 days per week- ...Ensure the pharmacy and staff comply with federal, state, and local pharmacy laws and... ...Maintain compliance with HIPAA and Fraud, Waste, and Abuse requirements. Ensure adherence to... ...employers. While we originally focused on healthcare staffing, we’ve expanded into legal...FraudFull timeLocal areaMonday to Friday
$89.61k
...places a focus on assistance for crime victims while simultaneously... ...agencies and government and financial institutions. Assist investigators... ...larceny, financial crimes, fraud, and identity theft. As per NY... ...background check to carry a firearm. SENIOR RACKETS INVESTIGATOR - 30831...SeniorFraudFull timeWork at officeWeekend workAfternoon shift$33.88 - $42.35 per hour
...clinical documentation. Assists healthcare providers to understand... ...program Personal and financial wellness programs Pre-... ...and billing guidelines and federal and state initiatives regarding... ...of provider engagement in fraud, waste and abuse. Provides guidance to...FraudContract workWork experience placementFlexible hours- ...compliance, and fraud, waste, and abuse (FWA) across Health... ...compliance with federal and state... ...leadership across financial, reimbursement,... ...Medicaid finance, healthcare finance, reimbursement... ...director, or consulting roles supporting... ...and trust with senior government and...FraudH1bLocal area
$150k - $185k
Senior Data Scientist - Computer Vision Title of Role: Senior Data Scientist... ...Development, AI, Cybersecurity, Fintech, Financial Services, Government, Healthcare, Gaming, Ecommerce, Enterprise,... ...digital identity verification and fraud solutions. This company is at the forefront...SeniorFraudWork at officeRemote work$500 per month
...Amongst our subsidiaries, Alpaca is a licensed financial services company, serving hundreds of... ...in supporting the firm's BSA/AML, Anti-Fraud, and Securities Fraud Monitoring programs... ...account manipulation, and other financial crimes identified through transaction monitoring...SeniorFraudRemote workHome office$200k - $255k
...Garner is on a mission to transform the U.S. healthcare system — and we're the only proven player... ...the role: We are seeking an exceptional Senior Software Engineer to join our Engineering... ..., 401(k), Teladoc Health and more. Fraud and Security Notice: Please be aware of...SeniorFraudRemote workFlexible hours$212k - $265k
...people. Headway's mission is to fix this by building a new mental healthcare system everyone can access. We started by solving the biggest... ...: To protect yourself against phishing and recruitment fraud, please note that Headway only accepts applications through our...SeniorFraudWork from homeFlexible hours- ...learning in risk decisioning is growing fast in scope and in stakes. Models increasingly drive real-time decisions about fraud and financial crime, and the Machine Learning Platform (MLP) team exists to build a paved path from a trained model to a reliable production deployment...SeniorFraudFull time
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