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
- ...accordance with current federal, state, and... ...of Nursing Services or Nurse... ...suspected incidents of fraud to the... ...OSHA, TB, HIPAA, Abuse Prevention, Safety... ...manner to avoid waste. Ensure that... ...questions from managers and employees.... ...of post-acute healthcare and support services...FraudTraineeshipWork at officeLocal areaRelocation packageShift workWeekend work
- ...The Investigator V at the Texas Health and Human Services Commission is responsible for conducting advanced investigations into Medicaid fraud, waste, and abuse. You will coordinate with MCOs, DMOs, and agencies, manage case files, and testify when required. The role...FraudRemote work
- ...Guidehouse is seeking experienced professionals in Financial Management, Internal Controls, Fraud Risk, and Business Process Improvement to support a Department... ...current processes, identifying risks, and advising federal stakeholders to achieve audit readiness and robust...Fraud
- ...accomplish big projects? If so, then the Financial Crimes Operations Manager position could be your calling.At Frost,... ...legacy of providing unparalleled banking services.Who you are: As a Financial CrimesOperations Manager - Fraud Tactics and Analytics, you are our leader...FraudFull time
- ...KPMG is currently seeking a Manager to join our Federal Advisory practice.... ...compliance, A-136, and areas within financial management for... ...standard work hours, and years of service, KPMG LLP provides a Total... ...domestic violence or sexual abuse or any other legally protected...SuggestedLocal area
- ...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
- ...biomedical discovery and healthcare within one visionary... ..., Economics, Finance, Management, Operations and... ...Principles of Accounting I (financial accounting), Principles... ..., cost accounting, federal income taxation, auditing... ...Auditor, Certified Fraud Examiner, and Enrolled...FraudPart timeFixed term contractWork experience placementLocal areaAfternoon shift
$78.91k - $197.1k
...team helping to enforce Federal criminal and civil laws... ...organized crime. Our mission is to enforce... ...recovering money procured via fraud against the government... ..., civility, and public service. You must meet all qualification... ...Office of Personnel Management (OPM) must authorize...FraudPermanent employmentWork at officeRelocation$85k - $141k
Job Family:Financial Account SpecialistTravel Required... ...of Credit Risk Management (OCRM) by performing... ...across origination, servicing, liquidation, and targeted... ...and maintain a federal Public Trust.Bachelor... ...reviews related to fraud, waste, and abuse.Experience working with...FraudFull timeWork at officeRemote workFlexible hours$62.7k - $157.1k
...agents, biohazardous waste and any other material... ...nursing assessment and management in addition to the clinical... ...other members of the healthcare team to ensure patient... ...of clinical research services, commercial insights... ...policy for candidate fraud. All information and credentials...FraudFull timePart timeImmediate startWorldwide$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...FraudFull timeContract workWork at officeLocal areaImmediate start$80k - $133k
...outside of San Antonio as well.The Patient Financial Services Assoc. Director (Hospital Revenue Cycle) is responsible for the overall management of the Hospital Client PFS department... ....Leverage extensive experience with healthcare hospital billing systems including electronic...Full timeWork at officeRemote workFlexible hours$51.63k - $124.72k
...organizations and the largest federal law enforcement agency within... ...make arrests, and investigate crimes, performing primary duties in... ...Leading investigations of fraud, contraband, criminal activity... ...also be eligible for an excepted service Veterans Recruitment Appointment...FraudFull timeWork experience placementImmediate startNight shift- ...USAA Life Insurance Company is seeking an accomplished executive to serve as AVP of Claims, Fraud & Financial Crimes. The role shapes the future of claims administration, fraud prevention, AML and financial crime programs across Life, Health and Annuity products. Reporting...Fraud
$18.75 - $24.25 per hour
...providers regarding benefits and services, resolving member and provider issues... ...(HIPAA) related policies such as Abuse, Neglect and Exploitation (ANE), Fraud, Waste, and Abuse (FWA) in regards to... ...resolution and experience with special healthcare members is preferred....FraudFull time$55.5k
...consulting and audit services to help our Federal, State, Local and... ...safety; improving healthcare for our military,... ...-based work and managed services to our government... ...aligned to our Financial Risk, Financial Crime & Grants team. The... ...‑integrity, fraud‑prevention, financial...FraudSummer holidayLocal areaFlexible hours$22.1 - $38.25 per hour
...the Special Investigations Unit (SIU) Manager. Performs at the advanced skill level of... ...administrative investigations related to fraud and abuse. Will conduct research related to... ...documentation to ensure compliance with federal and state laws and regulations. Responsible...FraudFull timeContract workFor contractorsWork at office$125k
...Territory Account Manager Heartflow is a medical technology company... ...for exceptional strides in healthcare innovation, is supported by... ...other status protected under federal, state, or local law. This policy... ...has become aware of a fraud where unknown entities are posing...FraudBase plus commissionWork experience placementWork at officeLocal areaWorldwideRelocationHome office$96.8k - $145.2k
...is a global leader in healthcare technology with a Mission... ...awareness within the service line to champion HTN... ...customer relationship management software to input and... ...employment. Recruitment Fraud AlertWe are aware of... ...offered rate complies with federal and local regulations...FraudFull timeH1bWork at officeLocal areaImmediate startRemote workFlexible hours- ...and all applicable healthcare laws, regulations, and... ...law, revenue cycle management, and compliance-related... ...potential federal or state exclusion matches... ...Medicare and Medicaid fraud, waste, and abuse regulations.... ...Experience analyzing financial and operational data...FraudFor contractorsInterim roleWork at officeLocal areaRemote work
- ...Five Years of ServiceRyan is growing our Federal Income Tax Consulting practice—focused... ...professionals at the Director and/or Senior Manager levels who are currently working in... ...Income Tax to provide income tax consulting services to corporate clients. Depending on level...Full timeFlexible hours
- ...is a global leader in healthcare technology with a Mission... ...orientation, adept management of product approval processes... ...and territory financial analysis; preferred knowledge... .... Recruitment Fraud Alert We are aware... ...offered rate complies with federal and local regulations...FraudH1bWork at officeLocal areaImmediate startFlexible hours
- ...-home & virtual cancer care services Industry Hospital & Health... ...law, with a focus on healthcare, and a proven track record in... ...Deep knowledge of healthcare fraud and abuse laws, including Stark, AKS,... ...paced environment. Hiring Manager Title CEO Functions...Fraud
- ...is searching for a Senior Financial Quality Assurance Specialist... ...expert-level financial management experience and a strong commitment... ...initiatives to prevent waste fraud and abuse. They will provide... ...civilian employment in the Federal Service are subject to the DoD Policy...FraudFull timeRemote workRelocation
- ...Finance oversees all financial operations and programmatic... ...include managing the day-to-day administrative... ...with all government (federal and state) regulations... ...reduce risk of error or fraud. *Ensure accurate... ...accounts; coordinate account services, authorized users,...FraudContract workWork at officeLocal areaNight shift
- ...internal control structures to prevent and detect errors, fraud, waste, and abuse. - Assist in other audits and investigations with approval... ...environment. If you are passionate about integrity in healthcare and possess the skills and qualifications to make a...Fraud
- ...Industry Information Services Type Privately Held, VC... ...and sanctions compliance financial crime intelligence ai agents for... ...all-source investigations fraud detection and investigation... ...the organization. Hiring Manager Title Chief Revenue Officer...Fraud
- ...Ryan is growing its Federal Income Tax Consulting practice across the United States and is seeking exceptional Directors and Senior Managers. The role focuses on accounting for income taxes (ASC 740) for public and private companies, with hands-on experience in preparing...
- ...Industry Information Services Type Privately Held, VC... ...and sanctions compliance financial crime intelligence ai agents for... ...all-source investigations fraud detection and investigation... ...Counsel will also be involved in managing and developing a team of...Fraud
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