Senior Fraud Risk Analyst & Audit Advisor

Blue Shield of California; California (MO); Hybrid; USD 91,000 - 136,000; Full time

Job summary

Blue Shield of California is seeking an Internal Audit Fraud Advisor to serve as a fraud subject matter expert, supporting audits, proactive detection, and advisory efforts to prevent, identify, and remediate fraud risk enterprise-wide.

The role partners with auditors, compliance, legal, HR, finance, and IT to identify fraud scenarios, evaluate controls, and develop practical detection strategies that safeguard members, providers, employees, and other stakeholders.

Qualifications

• Bachelor’s degree in Accounting, Finance, Business Admin, or related field; equivalent experience considered.
• Minimum 5 years in internal audit, compliance, investigations, or fraud risk management, preferably in regulated industries.
• Subject matter expertise in fraud risk and detection, control design, and analytics.
• CFE preferred; CIA, CPA, CISA, CAMS, CHC, or related credentials are an asset.
• Ability to evaluate processes, identify vulnerabilities, and recommend practical controls.
• Experience with data analysis, fraud analytics, or investigative case support.
• Strong communication of fraud risk to teams and leadership.
• Familiarity with audit standards, compliance, ethics, and internal control frameworks.

Responsibilities

• Provide fraud SME support during planning, risk assessments, testing, root cause analysis, and reporting.
• Identify fraud risk considerations across audits of processes, third parties, finance, claims, procurement, and operations.
• Perform proactive fraud detection using data analytics, pattern identification, anomaly review, and monitoring.
• Develop fraud scenarios, indicators, and detec­tion logic for audit programs and dashboards.
• Advise business units on anti-fraud practices, controls, and sustainable monitoring.
• Collaborate with multiple stakeholders to assess fraud risks and support remediation actions.
• Prepare workpapers and executive-ready insights linking fraud risks to controls and impact.
• Monitor emerging fraud schemes and regulatory expectations to enhance coverage.

Skills

Fraud risk knowledge

Analytical skills

Communication

Professional skepticism

Education

Bachelor's degree in Accounting, Finance, or related field

CFE preferred

Tools

SQL

Python

Excel

Tableau/Power BI

Job description

Blue Shield of California is seeking an Internal Audit Fraud Advisor to serve as a fraud subject matter expert, supporting audits, proactive detection, and advisory efforts to prevent, identify, and remediate fraud risk enterprise-wide.

The role partners with auditors, compliance, legal, HR, finance, and IT to identify fraud scenarios, evaluate controls, and develop practical detection strategies that safeguard members, providers, employees, and other stakeholders.