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Remote Fraud Analytics Jobs in Virginia (NOW HIRING)

Andesite

General Interest Application

Mclean, VA · On-site +1

McLean, VA (hybrid) or Remote (in United States) Cybersecurity analysts are drowning in an ... These providers include applicant tracking systems, candidate verification platforms, and fraud ...

Ferguson Enterprises, LLC

IT Auditor

Springfield, VA · On-site +1

... fraud risk indicators and gathering relevant information for analysis. * Enhances risk coverage and ... Experience working in a remote environment a plus. * A professional certification is required ...

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What is the difference between Remote Fraud Analytics vs Remote Fraud Prevention Specialist?

AspectRemote Fraud AnalyticsRemote Fraud Prevention Specialist
Primary FocusAnalyzing data to detect and investigate fraud patternsImplementing strategies and actions to prevent fraud
Required SkillsData analysis, statistical tools, fraud detection techniquesRisk assessment, policy enforcement, customer communication
Work EnvironmentData teams, analytics platforms, remote data analysisCustomer service, compliance teams, remote monitoring
Common CertificationsCertified Fraud Examiner (CFE), data analysis certificationsCertified Fraud Examiner (CFE), security certifications

Remote Fraud Analytics focuses on analyzing data to identify potential fraud activities, while Remote Fraud Prevention Specialist works proactively to prevent fraud through policy enforcement and customer engagement. Both roles often collaborate but serve different stages of fraud management.

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Remote Fraud Analytics jobs near you
Director, Compliance Data Insights and Analytics (Remote)

Director, Compliance Data Insights and Analytics (Remote)

Aledade

Arlington, VA • On-site, Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 21 days ago

Aledade rating

8.5

Company rating: 8.5 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

47th of 424 rated business services

Job description

The Director of Compliance Technology & Data Insights plays a crucial leadership role within Aledade's Compliance & Risk organization, dedicated to advancing data-driven insights and ensuring a compliant-by-design organization. This position not only develops and oversees analytical strategies but also leads initiatives around data integration and predictive modeling to enhance compliance operations. The director will work in close partnership with senior leaders across various departments to foster a culture of accountability and optimally leverage data for compliance purposes.
 
We are flexible with respect to geographic location, and the ideal candidate will be comfortable working remotely/work from home within the US or be based from Bethesda, MD office.
Primary Duties:
  • Advanced Data Analysis: Perform complex data mining and trend analysis to proactively assess compliance risks and enhance monitoring mechanisms, guiding the organization toward preventive measures.
  • Strategic Dashboard Development: Create comprehensive compliance dashboards and automated reporting systems to enhance compliance program maturity and effectiveness, and to provide real-time insights into compliance performance and business insights.
  • Predictive Modeling Leadership: Develop and implement predictive models to assess risk and identify strategic areas for compliance intervention, while optimizing resource allocation.
  • Technology and System Optimization Leadership: Drive technological initiatives and system optimizations to align compliance operations with cutting-edge data analytics processes; develop automation to identify abnormalities and outliers that may be an indicator of non-compliance
  • Cross-Departmental Leadership: Work cross-functionally to support all compliance functions (e.g., investigations, monitoring, risk assessment) to address compliance-related issues and help support the implementation of effective controls; Spearhead collaborative efforts across Product, Tech, BI, and other departments to ensure seamless data integration and process improvement, advocating for technological enhancements and compliance innovations.
  • Analytical Strategy and Executive Reporting: Provide executive-level compliance insight based on data analytics to facilitate compliance discussions at the Board of Directors and Compliance Committee level; Develop metrics to measure progress against compliance program maturity model goals; Collaborate with the Compliance leadership to assess current program maturity levels and identify opportunities for enhancement.
Minimum Qualifications:
  • Bachelor's degree or equivalent combination of education and experience. 
  • Minimum of 8 years of progressive experience in data analytics with a strong focus on healthcare compliance program management, monitoring, auditing, or a combination of these areas.
  • Proficiency in Tableau, SQL, and visualization tools
  • Strong knowledge of HIPAA, fraud, waste, and abuse laws (Stark Law, Anti-Kickback Statute, False Claims Act).
  • Excellent analytical, problem-solving, and critical thinking skills.
  • Exceptional written and verbal communication skills, with the ability to translate complex data findings into clear and actionable guidance.
  • Strong interpersonal skills and the ability to collaborate effectively with diverse teams.
Preferred knowledge, skills, and/or abilities:
  • Understanding of healthcare regulations, including those specific to Accountable Care Organizations (ACOs) and value-based care models (e.g., MSSP, Direct Contracting).
  • Compliance certification (e.g., CHC, CCEP).
  • Experience with compliance management software or platforms.
  • Experience working in a rapidly growing organization or startup environment.
  • Familiarity with compliance program maturity models (e.g., OIG Seven Elements, DOJ Guidelines).
  • Proficiency in G-Suite or Microsoft Office Suite.
Physical Requirements:
  • Prolonged periods of sitting at a desk and working on a computer.
#LI-KC1

Who We Are:
Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.

What Does This Mean for You?
At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.

In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:

Flexible work schedules and the ability to work remotely are available for many roles
Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners
Robust time-off plan (21 days of PTO in your first year)
Two paid volunteer days and 11 paid holidays
12 weeks paid parental leave for all new parents
Six weeks paid sabbatical after six years of service
Educational Assistant Program and Clinical Employee Reimbursement Program
401(k) with up to 4% match
Stock options
And much more!

At Aledade, we don't just accept differences, we celebrate them! We strive to attract, develop and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.

Privacy Policy: By applying for this job, you agree to Aledade's Applicant Privacy Policy available at  https://www.aledade.com/privacy-policy-applicants
We may use automated tools, including artificial intelligence (AI), to help organize and evaluate application materials. These tools support our recruiters and hiring managers by helping manage large applicant pools. Human judgment plays an essential role in our hiring process, including in the oversight and use of any automated tools. If you would like more information about our screening and hiring process, please contact us.
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About Aledade

Sourced by ZipRecruiter

Aledade is a leader in population health that is using innovative, value based solutions to transform the way physicians interact with their patients. We are on a mission to change healthcare for the better and solve complex problems within the healthcare system. We follow the simple but radical idea that Aledade only succeeds when our partner practices succeed. From our cutting-edge technology platform to practice transformation services, we provide physicians with everything they need to create and run an accountable care organization (ACO), revamping the way they practice and getting them back to where they should be: quarterbacking their patients' health care! Our customized solutions help clinicians in communities across America preserve their autonomy, deliver better care to their patients, reduce overall costs, and keep independent physician practices flourishing.

Industry

Health care and social assistance

Company size

501 - 1,000 Employees

Headquarters location

Bethesda, MD, US

Year founded

2014

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