This role defines fraud capability needs, shapes investment priorities, and translates fraud risk, policy, governance, and operational needs into clear requirements, prioritization recommendations ...
This role defines fraud capability needs, shapes investment priorities, and translates fraud risk, policy, governance, and operational needs into clear requirements, prioritization recommendations ...
Senior Data Analyst - Fraud, Waste, and Abuse - Remote
Eden Prairie, MN · On-site +1
$91K - $163K/yr
The Fraud, Waste, and Abuse (FWA) Analyst plays a critical role in safeguarding state Medicaid programs by identifying, analyzing, and preventing fraudulent activities within Medicaid claims. You ...
Senior Data Analyst - Fraud, Waste, and Abuse - Remote
Eden Prairie, MN · On-site +1
$91K - $163K/yr
The Fraud, Waste, and Abuse (FWA) Analyst plays a critical role in safeguarding state Medicaid programs by identifying, analyzing, and preventing fraudulent activities within Medicaid claims. You ...
Senior Data Analyst - Fraud, Waste, and Abuse - Remote
Eden Prairie, MN · Remote
$91K - $163K/yr
The Fraud, Waste, and Abuse (FWA) Analyst plays a critical role in safeguarding state Medicaid programs by identifying, analyzing, and preventing fraudulent activities within Medicaid claims. You ...
Senior Data Analyst - Fraud, Waste, and Abuse - Remote
Eden Prairie, MN · Remote
$91K - $163K/yr
The Fraud, Waste, and Abuse (FWA) Analyst plays a critical role in safeguarding state Medicaid programs by identifying, analyzing, and preventing fraudulent activities within Medicaid claims. You ...
Senior Product Manager - Fraud and Abuse Detection - Payment Integrity - Remote
Eden Prairie, MN · On-site +1
$129K - $170K/yr
Fight fraud at industry scale. You'll apply data science, network analytics, and machine learning to uncover emerging fraud patterns and turn them into detection capabilities and workflows that ...
Senior Product Manager - Fraud and Abuse Detection - Payment Integrity - Remote
Eden Prairie, MN · On-site +1
$129K - $170K/yr
Fight fraud at industry scale. You'll apply data science, network analytics, and machine learning to uncover emerging fraud patterns and turn them into detection capabilities and workflows that ...
Senior Product Manager - Fraud and Abuse Detection - Payment Integrity - Remote
Eden Prairie, MN · On-site +1
$129K - $170K/yr
Fight fraud at industry scale. You'll apply data science, network analytics, and machine learning to uncover emerging fraud patterns and turn them into detection capabilities and workflows that ...
Senior Product Manager - Fraud and Abuse Detection - Payment Integrity - Remote
Eden Prairie, MN · On-site +1
$129K - $170K/yr
Fight fraud at industry scale. You'll apply data science, network analytics, and machine learning to uncover emerging fraud patterns and turn them into detection capabilities and workflows that ...
Section Manager 2 - Fraud
Minnetonka, MN · On-site +1
$70K - $70K/yr
Duties and Responsibilities: * Manage multiple functions within the fraud prevention area ... Remote roles will also have the opportunity to come together in our offices for moments that matter.
Section Manager 2 - Fraud
Minnetonka, MN · On-site +1
$70K - $70K/yr
Duties and Responsibilities: * Manage multiple functions within the fraud prevention area ... Remote roles will also have the opportunity to come together in our offices for moments that matter.
Section Manager 2 - Fraud
Minnetonka, MN · On-site +1
$57K - $113K/yr
Duties and Responsibilities: * Manage multiple functions within the fraud prevention area ... Remote roles will also have the opportunity to come together in our offices for moments that matter.
Section Manager 2 - Fraud
Minnetonka, MN · On-site +1
$57K - $113K/yr
Duties and Responsibilities: * Manage multiple functions within the fraud prevention area ... Remote roles will also have the opportunity to come together in our offices for moments that matter.
Corporate Security Analyst
Minneapolis, MN · Remote
$33/hr
... opportunity in Remote with an onsite work schedule. This is an excellent opportunity to join a ... fraud cases involving commercial enrollment, account changes, provider validation, and payment ...
Quick apply
Corporate Security Analyst
Minneapolis, MN · Remote
$33/hr
... opportunity in Remote with an onsite work schedule. This is an excellent opportunity to join a ... fraud cases involving commercial enrollment, account changes, provider validation, and payment ...
Business Security Product Group Manager
Minnetonka, MN · On-site +1
$93K - $141K/yr
Work closely with internal cross functional teams to manage this fraud prevention product group ... Remote roles will also have the opportunity to come together in our offices for moments that matter.
Business Security Product Group Manager
Minnetonka, MN · On-site +1
$93K - $141K/yr
Work closely with internal cross functional teams to manage this fraud prevention product group ... Remote roles will also have the opportunity to come together in our offices for moments that matter.
$95K - $112K/yr
This is a remote role open to any location in continental US Manulife is a leading international ... Review underwriting fraud referrals for appropriateness and assist management with book of business ...
$95K - $112K/yr
This is a remote role open to any location in continental US Manulife is a leading international ... Review underwriting fraud referrals for appropriateness and assist management with book of business ...
Sr Software Engineer - Remote
Eden Prairie, MN · Remote
$91K - $163K/yr
... fraud/abuse detection. In this role, you will play a key part in driving innovation by creating ... As a remote-friendly team, we offer flexible work arrangements and the chance to work with a ...
Sr Software Engineer - Remote
Eden Prairie, MN · Remote
$91K - $163K/yr
... fraud/abuse detection. In this role, you will play a key part in driving innovation by creating ... As a remote-friendly team, we offer flexible work arrangements and the chance to work with a ...
Lead AI/ML Engineer- Remote Nationwide or Hybrid in MN/DC
Eden Prairie, MN · On-site +1
$104K - $137K/yr
On the fraud side, you will combine real time ML with graph analytics to detect emerging hotspots, uncover collusive networks, and stop improper payments before they happen, then translate that ...
Lead AI/ML Engineer- Remote Nationwide or Hybrid in MN/DC
Eden Prairie, MN · On-site +1
$104K - $137K/yr
On the fraud side, you will combine real time ML with graph analytics to detect emerging hotspots, uncover collusive networks, and stop improper payments before they happen, then translate that ...
Lead AI/ML Engineer- Remote Nationwide or Hybrid in MN/DC
Eden Prairie, MN · On-site +1
$104K - $137K/yr
On the fraud side, you will combine real time ML with graph analytics to detect emerging hotspots, uncover collusive networks, and stop improper payments before they happen, then translate that ...
Lead AI/ML Engineer- Remote Nationwide or Hybrid in MN/DC
Eden Prairie, MN · On-site +1
$104K - $137K/yr
On the fraud side, you will combine real time ML with graph analytics to detect emerging hotspots, uncover collusive networks, and stop improper payments before they happen, then translate that ...
Actimize Lead Full-stack Engineer
Minnetonka, MN · On-site +1
$70K - $140K/yr
... Fraud software applications - specifically Actimize ActOne with experience in AML-CTR, AML-STAR ... Remote roles will also have the opportunity to come together in our offices for moments that matter.
Actimize Lead Full-stack Engineer
Minnetonka, MN · On-site +1
$70K - $140K/yr
... Fraud software applications - specifically Actimize ActOne with experience in AML-CTR, AML-STAR ... Remote roles will also have the opportunity to come together in our offices for moments that matter.
Actimize Lead Full-stack Engineer
Minneapolis, MN · On-site +1
$70K - $140K/yr
... Fraud software applications - specifically Actimize ActOne with experience in AML-CTR, AML-STAR ... Remote roles will also have the opportunity to come together in our offices for moments that matter.
Actimize Lead Full-stack Engineer
Minneapolis, MN · On-site +1
$70K - $140K/yr
... Fraud software applications - specifically Actimize ActOne with experience in AML-CTR, AML-STAR ... Remote roles will also have the opportunity to come together in our offices for moments that matter.
Licensed Mental Health Therapist
Minneapolis, MN · Remote
$75K - $85K/yr
Work Type: 100% Remote (W-2) At Charlie Health, we prioritize an exceptional employee experience ... Please be cautious of potential recruitment fraud. If you are interested in exploring opportunities ...
Quick apply
Licensed Mental Health Therapist
Minneapolis, MN · Remote
$75K - $85K/yr
Work Type: 100% Remote (W-2) At Charlie Health, we prioritize an exceptional employee experience ... Please be cautious of potential recruitment fraud. If you are interested in exploring opportunities ...
Fully Remote Customer Service Representative
Plymouth, MN · On-site +1
$17 - $23/hr
Empower Your Career - 100% Remote Opportunity Ready to achieve professional success without sacrificing time with the people who matter most? Join our fully virtual, work-from-home team where ...
Fully Remote Customer Service Representative
Plymouth, MN · On-site +1
$17 - $23/hr
Empower Your Career - 100% Remote Opportunity Ready to achieve professional success without sacrificing time with the people who matter most? Join our fully virtual, work-from-home team where ...
SIU Lead Investigator
Minneapolis, MN · Remote
$102K - $121K/yr
Employees are responsible for triaging, investigating, and resolving potential instances of healthcare fraud and/or abusive conduct by medical professionals or providers. Using information from tips ...
SIU Lead Investigator
Minneapolis, MN · Remote
$102K - $121K/yr
Employees are responsible for triaging, investigating, and resolving potential instances of healthcare fraud and/or abusive conduct by medical professionals or providers. Using information from tips ...
Remote: You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on ... Identifies aberrant billing patterns and trends, evidence of fraud, waste or abuse, and recommends ...
Remote: You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on ... Identifies aberrant billing patterns and trends, evidence of fraud, waste or abuse, and recommends ...
Product Management
Minneapolis, MN · Remote
Join a dynamic product management role supporting a fully remote, long-term initiative with a fast ... Collaborate with risk, fraud, and other internal groups to support process adherence and product ...
New
Product Management
Minneapolis, MN · Remote
Join a dynamic product management role supporting a fully remote, long-term initiative with a fast ... Collaborate with risk, fraud, and other internal groups to support process adherence and product ...
New
Remote Fraud information
What are some common challenges faced by professionals working in remote fraud detection roles?
What are the key skills and qualifications needed to thrive as a remote fraud analyst, and why are they important?
What is a remote fraud job?
What is the difference between Remote Fraud vs Remote Fraud Analyst?
| Aspect | Remote Fraud | Remote Fraud Analyst |
|---|---|---|
| Credentials | Typically requires knowledge of fraud prevention, certifications like CFE or CFCS beneficial | Requires similar certifications, often with experience in fraud detection and analysis |
| Work Environment | Remote, often part of a fraud prevention or security team within a company | Remote, usually within a security or risk management department |
| Industry Usage | Used broadly across finance, e-commerce, banking, and insurance sectors | Commonly found in finance, banking, and online retail industries |
Remote Fraud refers to the broader role of preventing and managing fraud remotely across various industries. Remote Fraud Analyst is a specific position focused on analyzing fraud cases, detecting patterns, and implementing prevention strategies. While both roles require similar skills and certifications, the Fraud Analyst typically performs detailed investigations and analysis, whereas Remote Fraud may encompass broader responsibilities in fraud prevention strategies.

Director, Enterprise Fraud Platforms & Capabilities - Remote
Eden Prairie, MN • On-site, Remote
Full-time
Retirement
Posted 8 days ago
UnitedHealth Group rating
7.6
Based on 146 frontline employees who took The Breakroom Quiz
188th of 887 rated healthcare providers
Job description
Optum Financial protects customers and the business by preventing, detecting, and responding to fraud. We are seeking a senior strategic leader to direct fraud platforms and capabilities for the Directed Spend and Commercial Payments Fraud Operations programs. This role defines fraud capability needs, shapes investment priorities, and translates fraud risk, policy, governance, and operational needs into clear requirements, prioritization recommendations, delivery readiness, and measurable outcomes. The role partners closely with centralized Product and Technology teams to ensure solutions are scalable, defensible, operationally durable, and usable by Fraud Operations and other first-line teams. It also supports these solutions through enterprise roadmap, capital planning, change control, and release processes.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
- Define fraud platform and capability needs for Directed Spend and Commercial Payments Fraud Operations. Translate fraud strategy, standards, and roadmap priorities into executable plans aligned with risk appetite, regulatory requirements, business objectives, and governance expectations
- Lead cross-functional alignment with enterprise partners on priority threats, required capabilities, delivery sequencing, approval decisions, and escalation expectations
- Establish performance baselines, set targets, and drive measurable improvement across fraud losses, detection quality, response speed, operational efficiency, control effectiveness, and customer experience through platform and capability enhancements
- Ensure platform design considers fraud agent usability and operational experience, including workflows, alerts, queues, case views, and reporting outputs that support efficient investigation, consistent decisioning, quality control, and frontline adoption
- Ensure fraud decisioning, alerting, monitoring, case management, systems, and tools integrate effectively into operating workflows, procedures, training materials, reporting routines, oversight processes, and evidence repositories
- Lead fraud control readiness reviews for new or modified solutions. Ensure controls, monitoring, procedures, testing evidence, documentation, launch criteria, and post-launch ownership expectations are complete before deployment
- Direct requirements definition, prioritization recommendations, implementation support, adoption planning, and launch preparation from pilot through rollout and ongoing performance measurement
- Partner with Technology, Data Science, Product, Fraud Operations, Procurement, and business leaders to define fraud capability priorities, align delivery plans, resolve dependencies, and support disciplined implementation tradeoffs
- Coordinate governance routines, approval pathways, and escalation mechanisms with cross-functional and second-line partners. Ensure decision inputs, risks, dependencies, and ownership expectations are clearly documented
- Represent platform and capability readiness in second-line assessments. Provide evidence and walkthroughs, respond to credible challenge, and drive actions, issues, and remediation commitments to closure
- Maintain KPI scorecards, KRIs where applicable, and operating review materials using enterprise definitions and reporting standards to track progress, elevate decisions, and support governance routines
Decision Rights and Ways of Working:
- Owns: Fraud platform and capability needs, execution plans, requirements, prioritization recommendations, delivery readiness inputs, KPI/KRI operationalization, readiness assessments, adoption support, and performance measurement for assigned solutions
- Partners: Product, Technology, Data Science, Directed Spend and Commercial Payments Fraud Operations, Procurement as applicable, Compliance, Legal, Risk, Privacy, business leaders, and the independent second-line Fraud Risk Assessment Program
- Influences: Platform priorities, investment decisions, delivery sequencing, capability requirements, vendor direction, and governance outcomes through documented requirements, business cases, impact sizing, risk assessment, readiness inputs, and decision recommendations
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
- Bachelor's degree in Business, Finance, Computer Science, Engineering, or a related field
- 10+ years of progressive leadership experience in fraud, payments, risk, financial services, operations, platform management, or technology delivery, including ownership of enterprise-scale capabilities and cross-functional initiatives
- 5+ years leading fraud or risk platform programs, delivering measurable outcomes in fraud loss reduction, operational efficiency, customer experience, and regulatory compliance
- 5+ years implementing or enhancing fraud technologies, including decision engines, case management platforms, monitoring tools, alerting frameworks, and performance measurement solutions
- 5+ years leading control readiness, governance, or oversight activities for new or enhanced capabilities, including change management, testing oversight, monitoring controls, release approvals, evidence documentation, and post-implementation performance reviews
- 3+ years partnering with analytics and data science teams to support model governance, performance monitoring, testing, and controlled production deployments
- Proven ability to influence and align executive stakeholders across business, product, technology, operations, risk, compliance, and governance functions
- Experience translating business, policy, regulatory, and risk requirements into scalable platform capabilities, operational controls, and measurable outcomes
- Demonstrated expertise in fraud risk management across payments fraud, account takeover, identity fraud, servicing fraud, controls governance, and issue remediation within a regulated financial environment
- Demonstrated success managing regulatory findings, issue remediation, and corrective action plans in partnership with Compliance, Legal, Risk, Audit, and other second-line functions
Preferred Qualifications:
- Master's degree or relevant industry certifications
- Experience with healthcare payments, directed spend products, commercial payments, benefits administration, or adjacent domains with complex fraud and risk considerations
- Hands-on experience with fraud decisioning, case management, real-time rules, monitoring, identity controls, and account takeover controls
- Experience operating within enterprise delivery, capital planning, or scaled agile environments.
- Proven solid communication and influence skills, including the ability to frame complex tradeoffs, secure alignment, and support clear decision-making across business, product, technology, operations, risk, and governance partners
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $134,600 to $230,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
What UnitedHealth Group employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About UnitedHealth Group
Sourced by ZipRecruiter
Industry
Insurance services
Company size
10,000+ Employees
Headquarters location
Minnetonka, MN, US
Year founded
1977