Manager – Financial Crime Services - Federal Healthcare Fraud, Waste, And Abuse

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 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 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 degree
• 6+ years of experience in healthcare fraud and/or program integrity
• 6+ 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

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 documentation
• Ability to synthesize open-source and public information into actionable insights
• Experience 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.