Manager, Enterprise Operations & Risk- Health Investigations

Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk and an evolving regulatory environment into defensible actions that strengthen, protect, and transform their organization. Join our team and use advanced data, AI, and emerging technologies with industry insights to help clients bring clarity from complexity and accelerate their path to value creation.

Work You'll Do

As a Healthcare, Project Delivery Manager Lead:

• You will lead a team investigating suspected healthcare fraud, from detection through referral.
• Manage specialized databases, custom applications, and configuration; partner with government leaders, law enforcement, and case teams to build defensible investigative and referral processes that meet quality and evidentiary standards.
• Direct vulnerability detection, workflow, quality review, and findings presentations to leadership.
• Oversee collections, productions, archiving, and risk analysis.
• Support AI-enabled workflows alongside analytics teams handling structured and unstructured data.
• Analyze claims data and open-source information to detect emerging fraud schemes, suspicious billing, and identity theft.
• Generate proactive referrals using external sources such as OIG reports and social media, and identify program vulnerabilities through data analytics.

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.

The Project Talent Model is designed for professionals with specialized skills that align to a current client need. Team members focus on delivering services to clients, without additional expectations related to business development or promotion. Their employment is tied to their role on a project, and they are eligible for a benefits package that is competitive for project-focused professionals.

Qualifications

Required:

• Bachelor's degree
• Professional experience in/with: Claims Analysis, Claims Fraud-Insurance Sector
• 2-5 years professional experience with Health Insurance:
• Active Public Trust security clearance required
• Ability to travel 5-10%, 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:

• Certified Fraud Examiner (CFE)
• Independent and team-based work; strong written and verbal communication
• Attention to detail
• Relationship-building
• Project and workstream leadership
• Multitasking under deadlines
• Professional demeanor
• Mentoring ability

Deloitte is committed to providing reasonable accommodations for people with disabilities. If you require a reasonable accommodation to participate in the recruiting process, please direct your inquiries to the Global Call Center (GCC) at USTalentCICInbox@deloitte.com .