Vulnerabilities Investigator

Are you a driven problem solver looking to help our clients tackle some of the most pressing challenges within Government and Public Services (GPS)? Join Deloitte's Program Integrity practice to help government agencies protect taxpayer money. To address the threats that perpetuate fraud, waste, and abuse, our clients look to our team to provide the guidance and solutions required to help them stay ahead of emerging issues and protect the integrity of their programs. If you are looking for a rapidly growing, collaborative environment with opportunities to make an impact and grow, our Program Integrity team would be a great fit for you!

Recruiting for this role ends on February 19 , 2025.

Work you'll do

The Vulnerabilities Investigator reviews data analytics, open-source resources, policy analysis, and public information to identify potentially fraudulent Medicare and Medicaid providers. The Vulnerabilities Investigator is responsible for identifying and developing fraud referrals for the client, law enforcement and other government agencies. The Vulnerabilities Investigator is also responsible for connecting fraud referrals with potential program integrity vulnerabilities in the Medicare and Medicaid programs.

• Assist in the analysis of 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 Office of Inspector General Reports and open-source information, such as social media.
• Develop fraud referrals for presentation to the client, law enforcement, and other government agencies.
• Assist in the identification of Medicare and Medicaid program vulnerabilities through data analytics and open-source information.

The team

Deloitte's Government and 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 over 15,000 professionals brings fresh perspective to help clients anticipate disruption, reimagine the possible, and fulfill their mission promise.

We bring a rigorous approach to help government agencies effectively detect, prevent, and respond to issues related to fraud, waste, and abuse. Our team helps tackle these threats by bringing cutting edge analytics and AI experience with innovative mindsets. Our Program Integrity team focuses on thought diversity and collaborative problem solving to help clients address these challenges holistically, with a common goal to protect the integrity of their programs.

Qualifications

Required:

• Bachelors Degree in a related field
• Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future
• Must be able to obtain and maintain the required clearance for this role
• 2 years of experience conducting fraud investigations, health care experience preferred.
• Must have healthcare fraud and/or program integrity experience, Medicare and Medicaid experience
• Experience presenting to clients or other decision makers to represent and sell ideas to various audiences (technical and non-technical)
• Experience with Fraud Analytics
• Ability to present complex information to a wide range of stakeholders.
• Ability to travel 0-20%, on average, based on the work you do and the clients and industries/sectors you serve.

Preferred:

• Anti-Corruption experience
• CFE or AHFE Designation

The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $$72,889 to $127,875.

You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance.

Information for applicants with a need for accommodation: https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.htmlhttps://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html

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