Manager, Financial Crime Services - Federal Healthcare Fraud, Waste, and Abuse
About The Position
Deloitte’s Regulatory, Risk & Forensic team helps clients respond to multifaceted risks and evolving regulations through advanced data, AI, emerging technologies, and industry insights. 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. The work focuses on analyzing claims and public information to detect fraud, developing referrals, and identifying vulnerabilities in public health insurance programs. The role is part of Deloitte’s Government & Public Services practice and Enterprise Operations & Risk offering. The position is available in 16 U.S. locations. Travel is expected to average 5–25%, depending on the work and clients served.
Requirements
- Bachelor’s degree.
- At least 6 years of experience in healthcare fraud and/or program integrity.
- At least 6 years of experience supporting programs that identify and mitigate fraud, waste, or abuse.
- Ability to travel 5–25%, on average, based on the work and the clients and industries or sectors served.
- Must be legally authorized to work in the United States without employer sponsorship, now or in the future.
- Ability to work independently and collaboratively.
- Effective written and verbal communication skills.
- Meticulous attention to detail and quality of work.
- Ability to build and sustain professional relationships.
- Ability to manage and prioritize multiple tasks in a fast-paced, dynamic environment.
- Strong interpersonal skills and professional demeanor.
- Ability to meet deadlines.
- Ability to mentor and provide clear guidance to others.
Nice To Haves
- Experience presenting to clients or other decision makers and articulating ideas to technical and non-technical audiences.
- 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.
Responsibilities
- Analyze health insurance claims data, open-source information, and public information to identify emerging fraud schemes, suspicious billing patterns, and other potentially fraudulent behavior.
- Analyze open-source and public information to identify sources of identity theft.
- Generate proactive referrals based on external data, including 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.
- Lead projects or workstreams, manage and prioritize multiple tasks, meet deadlines, and mentor and guide others.
Benefits
- Employees are offered a broad range of benefits.
- Eligible employees may participate in a discretionary annual incentive program, subject to its governing rules and applicable factors.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
