D
Not Specified Permanent

Jersey City, New Jersey · USA job

Senior Consultant, Federal Healthcare Fraud, Waste, and Abuse Forensics & Investigations

Deloitte

Jersey City, New Jersey

Job description

Overview

In this role, you help detect and prevent fraud in a large federal health care program by applying data analytics and OSINT to uncover schemes. You work with a cross-functional team to build and present fraud referrals to clients, law enforcement, and agencies. You will analyze claims data, monitor public information, and identify vulnerabilities to strengthen program integrity. This is a mission-focused opportunity to scale investigative capabilities within Deloitte's GPS and Forensics teams.

Responsibilities
  • Analyze health insurance claims data, open source, and public information to identify new fraud schemes and suspicious billing patterns
  • Conduct OSINT to identify identity theft sources
  • Perform proactive referral generation using external data (government reports, OSINT, social media)
  • Develop fraud referrals for presentation to clients, law enforcement, and government agencies
  • Identify public health insurance program vulnerabilities through data analytics and open-source information
Key requirements
  • Bachelor's degree
  • 3+ years of healthcare fraud and/or program integrity experience
  • 3+ years of experience supporting programs identifying and mitigating fraud, waste, or abuse
  • Ability to travel 5-25%
  • Authorized to work in the United States without sponsorship
  • Ability to work independently and within a team
  • Effective written and verbal communication
  • Meticulous attention to detail
  • Open-source information analysis
  • Data analytics for fraud detection
  • Synthesis of public information into actionable insights

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