Senior Consultant, Financial Crime and Fraud - Federal Health... Jobs
Senior Consultant, Financial Crime and Fraud - Federal Health... Jobs
Posted 6 days ago
SENIORITY
Senior
About the role
- 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 team
- Effective written and verbal communication skills
- Meticulous attention to detail and quality of work product
- Ability to build and sustain professional relationships
- Ability to lead projects or workstreams
- Ability to manage and prioritize multiple tasks in a fast-paced and dynamic environment
- Strong interpersonal skills and professional demeanor
- Ability to meet deadlines
- Ability to provide clear guidance to others
- Bachelor's degree 3+ years of experience in healthcare fraud and/or program integrity 3+ 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 serve
- Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future
- 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 documentation
- Ability to synthesize open-source and public information into actionable insights
- Experience in healthcare policy, program integrity, or regulatory compliance domains
Before you apply
Applying takes about a minute. These four things decide how fast it moves after that.
Your profile is current
It's what we read first. Occupations, seniority and locations matter more than a long history.
Two examples you can talk through
Not a portfolio — just two pieces of work where you can explain the decisions and what you'd change.
A number in mind
What you're on now and what would make you move. We negotiate better when we know both.
Your notice period
Employers plan around it, and it's the question that stalls offers most often.
Once you apply, someone reads it and calls you before anything reaches the employer — usually within two working days.
