Federal Healthcare Fraud Senior Consultant, Data-Driven

Deloitte France; Los Angeles (CA); On-site; USD 96,000 - 188,000; Full time

Benefits offered by this job

Discretionary annual incentive program

Job summary

Deloitte GPS is seeking a Senior Consultant, Financial Crime and Fraud to join a cross-disciplinary team deploying a fraud detection accelerator for a large federal health care program. You will analyze claims data, open source information, and public data to identify fraud schemes and suspicious billing patterns.

The role requires strong communication, project leadership, and the ability to work independently in a fast-paced environment.

Qualifications

• Bachelor's degree in a relevant field.
• 3+ years of experience in healthcare fraud or program integrity.
• 3+ years supporting programs identifying and mitigating fraud, waste, or abuse.
• Ability to travel 5-25% on average.
• Must be legally authorized to work in the United States without sponsorship.
• Strong written and verbal communication skills.

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.

Skills

Independent work

Communication

Attention to detail

Relationship building

Project leadership

Multi-tasking

Interpersonal skills

Time management

Deadline oriented

Guidance to others

Education

Bachelor's degree

Job description

Deloitte GPS is seeking a Senior Consultant, Financial Crime and Fraud to join a cross-disciplinary team deploying a fraud detection accelerator for a large federal health care program. You will analyze claims data, open source information, and public data to identify fraud schemes and suspicious billing patterns.

The role requires strong communication, project leadership, and the ability to work independently in a fast-paced environment.