As a Senior Consultant, Forensics and Investigations, you will work with a cross disciplinary team to deploy a fraud detection accelerator for a large federal health care program.

Key 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.

The successful candidate would possess these skills:

• Ability to work independently and collaborate as part of a team
• Effective written and verbal communication skills
• Meticulous attention to detail and quality of work product
• Ability to build and sustain professional relationships
• Ability to lead projects or workstreams
• Ability to manage and prioritize multiple tasks in a fast-paced and dynamic environment
• Strong interpersonal skills and professional demeanor
• Ability to meet deadlines
• Ability to provide clear guidance to others

The Team

Deloitte’s Government & Public Services (GPS) practice – our people, ideas, technology and outcomes – is designed for impact. Serving federal, state, & local government clients as well as public higher education institutions, our team of professionals brings fresh perspective to help clients anticipate disruption, reimagine the possible, and fulfill their mission promise.

Our Forensic, Discovery, & Financial Crime offering provides services to support anti-money laundering, discovery, business disputes and investigations. Protect brands from financial crime and other corporate misconduct, as well as enable government organizations with tradecraft & technology to combat emerging and evolving threats.

Qualifications

Required:

• Bachelor’s degree
• 3+ years of experience in healthcare fraud and/or program integrity
• 3+ years of experience supporting programs identifying and mitigating fraud, waste, or abuse.
• Ability to travel 5-25%, on average, based on the work you do and the clients and industries/sectors you serve
• Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future

Preferred:

• Experience presenting to clients or other decision makers to represent and articulate ideas to various audiences (technical and non-technical)
• Excellent written communication skills, including experience drafting findings or referral documentation
• Ability to synthesize open-source and public information into actionable insights
• Experience in healthcare policy, program integrity, or regulatory compliance domains