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Senior Fraud Risk Analyst Jobs in Raleigh, NC (NOW HIRING)

Siri InfoSolutions Inc

Risk Analysis

Raleigh, NC · On-site

Job Summary - Risk Analysis (Raleigh, NC) - Identify, assess, and mitigate risks across business ... for senior leadership. - Develop and maintain risk dashboards, KRIs/KPIs, risk registers, and ...

Tata Consultancy Service Limited

Risk Analysis

Raleigh, NC · On-site

$100K - $120K/yr

Risk Analysis Must Have Technical/Functional Skills • Risk identification, assessment, mitigation ... senior leadership. • Adept at developing risk dashboards, KRIs/KPIs, risk registers, and ...

Robert Half

AML/KYC Analyst

Cary, NC · On-site

$30 - $35/hr

At least 2 years of experience in AML, KYC, fraud, risk, compliance, or a related financial crimes ... Ability to analyze case information thoroughly, identify relevant risk factors, and document ...

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Senior Fraud Risk Analyst information

See Raleigh, NC salary details

$52K

$106.8K

$138.5K

How much do senior fraud risk analyst jobs pay per year?

As of Sep 7, 2026, the average yearly pay for senior fraud risk analyst in Raleigh, NC is $106,779.00, according to ZipRecruiter salary data. Most workers in this role earn between $88,000.00 and $133,200.00 per year, depending on experience, location, and employer.

What does a senior fraud risk analyst do?

A Senior Fraud Risk Analyst is responsible for identifying, assessing, and mitigating risks related to fraudulent activities within an organization. They analyze data, investigate suspicious transactions, and develop strategies to prevent fraud. These professionals also collaborate with other departments, implement fraud detection systems, and ensure compliance with regulations. Their expertise helps protect the organization from financial losses and reputational damage.

How does a senior fraud risk analyst typically collaborate with other departments to identify and mitigate fraud risks?

Senior Fraud Risk Analysts often work closely with teams across the organization, such as compliance, IT, customer service, and legal departments. They collaborate to analyze transaction data, investigate suspicious patterns, and implement new fraud prevention strategies. Regular cross-functional meetings and sharing of insights are crucial to ensure that fraud risks are identified early and addressed effectively. This collaborative approach helps create a comprehensive defense against evolving fraud threats and supports a proactive risk management culture.

What are the key skills and qualifications needed to thrive as a senior fraud risk analyst, and why are they important?

To thrive as a Senior Fraud Risk Analyst, you need expertise in fraud detection, risk assessment, data analysis, and a bachelor's degree in finance, business, or a related field. Familiarity with anti-fraud software, data analytics tools like SQL or Python, and relevant certifications such as CFE (Certified Fraud Examiner) are highly valued. Strong problem-solving abilities, attention to detail, and effective communication skills help analysts spot patterns and present findings clearly. These skills are vital for identifying and mitigating fraud risks, protecting organizational assets, and ensuring compliance with regulations.

What is the difference between Senior Fraud Risk Analyst vs Fraud Investigator?

AspectSenior Fraud Risk AnalystFraud Investigator
CredentialsBachelor's degree, certifications like CFE or CPA often preferredBachelor's degree, CFE certification common
Work EnvironmentAnalytical, data-driven, risk assessment teamsInvestigative, interview-focused, field or office-based
Employer & IndustryFinancial institutions, insurance, e-commerceFinancial services, law enforcement, corporate security

While both roles focus on fraud prevention, the Senior Fraud Risk Analyst primarily assesses risks and develops strategies, whereas the Fraud Investigator conducts investigations into specific fraud cases. The analyst role is more analytical and strategic, while the investigator is more hands-on and investigative.

What are popular job titles related to Senior Fraud Risk Analyst jobs in Raleigh, NC?

For Senior Fraud Risk Analyst jobs in Raleigh, NC, the most frequently searched job titles are:

What job categories do people searching Senior Fraud Risk Analyst jobs in Raleigh, NC look for?

The top searched job categories for Senior Fraud Risk Analyst jobs in Raleigh, NC are:

What cities near Raleigh, NC are hiring for Senior Fraud Risk Analyst jobs?

Cities near Raleigh, NC with the most Senior Fraud Risk Analyst job openings:

Senior Fraud Risk Analyst jobs near you
Infographic showing various Senior Fraud Risk Analyst job openings in Raleigh, NC as of August 2026, with employment types broken down into 1% As Needed, 88% Full Time, 8% Part Time, and 3% Contract. Highlights an 88% Physical, 4% Hybrid, and 8% Remote job distribution, with an average salary of $106,779 per year, or $51.3 per hour.

Senior Population Risk Performance Analyst (Value-Based Care)

Blue Cross and Blue Shield of North Carolina

Chapel Hill, NC • On-site

$98K - $156K/yr

Other

Medical, Retirement, PTO

Posted 18 days ago

Blue Cross and Blue Shield of North Carolina rating

7.8

Company rating: 7.8 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

197th of 315 rated insurance

Job description

Job Description

This role is responsible for providing advanced analytical and modeling expertise supporting value-based care performance measurement and population risk normalization. The Sr. Population Risk Performance Analyst applies population risk models to attributed member populations to ensure accurate, consistent, and defensible financial and quality performance measurement across value-based care programs.
The role operationalizes risk and actuarial modeling methodologies to support total cost of care evaluation, performance reconciliation, forecasting, and provider settlement processes. This position partners closely with actuarial, finance, clinical economics, and value-based care operations teams to ensure performance outcomes appropriately reflect population acuity and contractual measurement intent.
This role is distinct from coding-based risk adjustment functions and focuses on performance measurement methodology and financial normalization.

What You Will Do

  • Apply population risk and actuarial models to normalize performance measurement across value-based care programs.
  • Operationalize CMS-HCC, Milliman, and comparable population risk methodologies for performance evaluation and financial measurement.
  • Support development and maintenance of risk-normalized total cost of care and quality performance metrics.
  • Validate performance measurement methodologies used in shared savings, downside risk, and alternative payment models.
  • Analyze population risk movement and evaluate impacts on program financial performance and provider outcomes.
  • Partner with actuarial and finance teams to align modeling assumptions with contractual measurement logic.

  • Identify and investigate performance variances driven by population acuity, attribution changes, coding variation, or data completeness.

  • Support performance year reconciliation, settlement calculations, and financial exposure analysis.
  • Define and document measurement methodologies, assumptions, and model governance controls.
  • Collaborate with analytics and data engineering teams to integrate risk modeling logic into reporting and measurement pipelines.
  • Provide analytical expertise supporting provider performance reviews and measurement inquiries.
  • Translate complex modeling outcomes into clear insights for operational and executive stakeholders.
  • Ensure consistency and repeatability of population measurement processesacross programs and performance periods.
  • Serve as subject matter expert for population risk interpretation supporting value-based care strategy and operations.

What You Bring

  • Bachelor's degree or advanced degree in healthcare administration, business, public health, or related field.

  • 5+ years of experience in related field.

  • In lieu of degree, 7+ years of experience in related field

  • Demonstrated experience working with population risk models including CMS-HCC and Milliman methodologies (or equivalent).
  • Experience analyzing healthcare claims and eligibility datasets.
  • Strong SQL and analytical data experience.
Preferred Qualifications

  • Experience supporting Medicare Advantage and Commercial value-based care programs.

  • Familiarity with total cost of care measurement and shared savings models.

  • Experience collaborating with actuarial, finance, or clinical economics teams.

  • Knowledge of attribution methodologies and population performance analytics.

  • Experience supporting provider settlement or reconciliation processes.

#LI-Hybrid

    Salary Range

    At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

    *Based on annual corporate goal achievement and individual performance.

    $98,092.00 - $156,947.00

    Skills

    Analytical Analysis, Data Analysis, Data Analysis Reporting, Data Analytics, Data Engineering, Data Governance, Data Mining, Data Science, Identifying Trends, Trend Analysis

    _____________________________________________________________________
    JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com.

    What Blue Cross and Blue Shield of North Carolina employees say

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