Fraud Prevention Lead - Healthcare & Federal Programs

Serco; Chesapeake (VA); Hybrid; USD 140,000 - 200,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

401(k) Matching

Tuition Reimbursement

Paid Time Off

Job summary

Serco Inc. seeks a senior manager to oversee fraud detection, escalation, and risk operations for a large federal contract from its Headquarters in Herndon, VA, reporting to the Director of Program Management.

The role includes strategy development, analytics, policy formation, and cross-functional leadership to mitigate health insurance fraud and ensure program integrity. The ideal candidate has 7+ years in healthcare compliance or related fields, strong leadership and communication skills, and

Qualifications

• Bachelor's degree or equivalent required.
• 7+ years in healthcare compliance, fraud investigations, law enforcement, government auditing or related fields.
• 5+ years leading integrated teams, projects, or cross-functional groups.
• Experience with compliance technology platforms and advanced data analytics for fraud detection.

Responsibilities

• Provide program integrity and fraud expertise to inform executives, staff, and federal partners.
• Evaluate rules, processes, and systems; assess risk and mitigations.
• Design a strategic fraud framework for program processes and systems.
• Lead a cross-functional team to identify and detect patterns of fraud in applications and verifications.
• Communicate across departments to support program integrity and mitigation initiatives.
• Collaborate with managers and staff to grow anti-fraud awareness and tools within the workforce.
• Manage complex projects to implement program integrity and fraud mitigation.
• Develop and oversee software-driven data collection and analysis system for fraud tracking.

Skills

Leadership

Communication

Data analytics

Fraud detection

Education

Bachelor's degree

Tools

Compliance platforms

Job description

Serco Inc. seeks a senior manager to oversee fraud detection, escalation, and risk operations for a large federal contract from its Headquarters in Herndon, VA, reporting to the Director of Program Management.

The role includes strategy development, analytics, policy formation, and cross-functional leadership to mitigate health insurance fraud and ensure program integrity. The ideal candidate has 7+ years in healthcare compliance or related fields, strong leadership and communication skills, and