Fraud Prevention Strategy & Analytics Leader

Serco; Glen Jean (WV); On-site; USD 120,000 - 180,000; Full time

Benefits offered by this job

Medical, dental, vision insurance

Paid time off & holidays

401(k) with match

Job summary

Serco Inc. seeks a Senior Manager to oversee fraud detection, escalation, and risk operations for a large federal contract at our DMV-area headquarters. You will coordinate monitoring, analytics, and technology to advance Serco’s Fraud Prevention program.

The role emphasizes strategic policy development, stakeholder engagement, and leadership of cross-functional teams to mitigate health insurance fraud in a fast-paced government environment.

Qualifications

• Undergraduate degree (B.A., B.S., or equivalent).
• At least 7 years of experience in healthcare compliance, fraud investigations, law enforcement, government auditing or oversight, or related fields.
• At least 5 years of experience in leading integrated teams, projects, initiatives, or cross-functional groups.
• Experience with compliance technology platforms and advanced data analytics for fraud detection.
• Excellent communication skills, both verbal and written; ability to tailor communication to technical and non-technical audiences.
• Strong leadership, stakeholder management and influencing skills.
• Strong organization skills with the ability to multitask and prioritize; ability to work under pressure and to tight deadlines.
• Strong analytical and problem-solving skills; ability to collaborate across departments.

Responsibilities

• Provide program integrity and fraud expertise to inform Serco executives, staff, and federal partners of latest data and trends in fraud.
• Evaluate program rules, processes, and systems; assess risk and mitigations based on current best practices.
• Design and incorporate a strategic fraud framework into program processes and systems.
• Lead a distributed, cross-functional team to examine and detect patterns of identity or eligibility fraud.
• Communicate effectively across departments and organizational levels to support program integrity and fraud mitigation operations.
• Build anti-fraud awareness and tools within Serco’s workforce across programs.

Skills

Fraud detection

Data analytics

Leadership

Cross-functional teamwork

Education

Bachelor's degree

Tools

Excel

Analytics platforms

Job description

Serco Inc. seeks a Senior Manager to oversee fraud detection, escalation, and risk operations for a large federal contract at our DMV-area headquarters. You will coordinate monitoring, analytics, and technology to advance Serco’s Fraud Prevention program.

The role emphasizes strategic policy development, stakeholder engagement, and leadership of cross-functional teams to mitigate health insurance fraud in a fast-paced government environment.