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Sr. Manager Fraud Prevention

Serco Inc

Position Description & Qualifications Serco Inc. is seeking a dynamic and highly skilled professional to oversee fraud detection and risk operations for a large federal contract at our Headquarters office in Herndon, VA. Reporting to the Director of Program Management, this role is responsible for oversight, monitoring, analysis, and technology in Serco’s emerging Fraud Prevention program. Responsibilities Lead a distributed team of investigators who examine paper and digital applications for evidence of benefits fraud and identity theft. Inform and communicate with Serco executives, staff, and federal partners of the latest data and trends in fraud within the boundaries of Serco’s contract. Manage a software driven information collection and analysis system used to track fraud and provide current data to help focus investigations, reviews, and spot checks. Collaborate with Serco managers and staff connected to other aspects of the contract to establish and grow anti-fraud awareness, techniques, and tools within the broader Serco workforce. Maintain an awareness of evolving and emerging healthcare fraud issues and incidents, liaise with federal, state, local, and private sector counterparts to understand emerging fraud tactics and techniques. Generate written and oral reports of current levels of fraud for dissemination inside and outside of Serco. Manage, coach, and mentor staff. Perform additional duties and special projects as assigned. Qualifications U.S. Citizenship required. Professional credentials such as: Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified Insurance Fraud Investigator (CIFI), Certified Internal Auditor (CIA), or similar relevant certifications. Undergraduate degree (B.A., B.S., or equivalent) required. Minimum 7 years of experience in healthcare compliance, fraud investigations, law enforcement, or related field. Minimum 5 years of experience in leading teams, projects, initiatives, or cross‑functional groups. Demonstrated experience managing complex investigations in a managed care or healthcare environment. Experience in coordinating with external regulators and law enforcement agencies. Experience with compliance technology platforms and advanced data analytics for fraud detection. Excellent communication skills, both verbal and written; ability to tailor communication to technical and non‑technical audiences. Strong interpersonal skills to work in a team‑oriented environment. Strong leadership, stakeholder management and influencing skills. Strong organizational skills with the ability to multitask, prioritize, and work under pressure and tight deadlines. Strong analytical and problem‑solving skills. Additional Desired Experience and Skills Prior leadership of a Special Investigations Unit (SIU) or equivalent function in a health plan, government agency, or large healthcare system. Proven knowledge of HHS, CMS, OIG, and DOJ regulatory frameworks governing health insurance programs. Advanced Microsoft Office skills, including strong data analysis capabilities. Equal Opportunity Employer Serco is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics. Pay Transparency Salary range for this position can be found at the top of this posting. The range is a general guideline and represents a good faith estimate across all experience levels. Actual base salary will be determined by a variety of factors, including but not limited to the scope of the role, relevant experience, job‑related knowledge, education and training, key skills, and geographic market considerations. In addition to base salary, eligible positions may include other forms of compensation such as annual bonuses or long‑term incentive opportunities. Benefits Medical, dental, and vision insurance. Robust vacation and sick leave benefits, and flexible work arrangements where permitted. 401(k) plan that includes employer matching funds. Tuition reimbursement program. Life insurance and disability coverage. Optional coverages that can be purchased, including pet insurance, home and auto insurance, additional life and accident insurance, critical illness insurance, group legal, ID theft protection. Birth, adoption, parental leave benefits. Employee Assistance Plan. Application Information The application window for this position is for no more than 60 days. We encourage candidates to apply promptly after the posting date, as the position may close earlier if filled or if the application volume exceeds expectations. #J-18808-Ljbffr

Vacancy posted 2 days ago
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