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Fraud Operations Manager
A company is looking for a Manager I, Fraud - Healthcare & Incentives. Key Responsibilities Establish and refine Standard Operating Procedures (SOPs) for fraud risk management Ensure compliance with healthcare benefits regulations and manage fraud case handling Leverage data analysis to optimize fraud detection and prevention strategies Required Qualifications 5+ years of experience in fraud prevention or risk management Experience with healthcare benefits fraud operations (FSA, HSA, WSA preferred) Strong knowledge of case management workflows and fraud risk controls Proficiency in data analysis tools such as Excel or SQL Experience with HIPAA and IRS regulatory frameworks
A company is looking for a Manager I, Fraud - Healthcare & Incentives.
Key Responsibilities
Establish and refine Standard Operating Procedures (SOPs) for fraud risk management
Ensure compliance with healthcare benefits regulations and manage fraud case handling
Leverage data analysis to optimize fraud detection and prevention strategies
Required Qualifications
5+ years of experience in fraud prevention or risk management
Experience with healthcare benefits fraud operations (FSA, HSA, WSA preferred)
Strong knowledge of case management workflows and fraud risk controls
Proficiency in data analysis tools such as Excel or SQL
Experience with HIPAA and IRS regulatory frameworks