Fraud Prevention Lead for Healthcare Programs

Serco; Vienna (VA); On-site; USD 140,000 - 190,000; Full time

Benefits offered by this job

Health insurance

401(k) plan

Paid time off

Tuition reimbursement

Job summary

Serco Inc. is seeking a dynamic Senior Manager to oversee fraud detection, escalation and risk operations for a major federal contract at our Herndon, VA headquarters. You will coordinate monitoring, analytics, and supporting technology within Serco’s Fraud Prevention program, reporting to the Director of Program Management.

The role requires leading a distributed, cross-functional team, developing fraud management policies, and delivering insights and recommendations to senior leadership. U.S.

Qualifications

• U.S. Citizenship required.
• Ability to obtain and/or maintain a public trust.
• Experience in healthcare compliance or fraud investigations is highly desirable.
• Experience leading cross-functional teams on complex investigations or audits.

Responsibilities

• Provide program integrity and fraud expertise to inform Serco executives, staff, and federal partners of trends in fraud.
• Evaluate program rules, processes, and systems and assess risk and mitigations strategies.
• Lead and coordinate a distributed, cross-functional team examining applications for patterns of eligibility or identity fraud.
• Develop and oversee a software driven information collection and analysis system to track fraud and focus investigations.
• Generate written and oral reports and presentations of current fraud levels for internal and external stakeholders.

Skills

Healthcare fraud experience

Leadership experience

Data analytics

Stakeholder management

Communication skills

Public trust / compliance

Education

Bachelor's degree

Job description

Serco Inc. is seeking a dynamic Senior Manager to oversee fraud detection, escalation and risk operations for a major federal contract at our Herndon, VA headquarters. You will coordinate monitoring, analytics, and supporting technology within Serco’s Fraud Prevention program, reporting to the Director of Program Management.

The role requires leading a distributed, cross-functional team, developing fraud management policies, and delivering insights and recommendations to senior leadership. U.S.