Manager I, Fraud - Healthcare & Incentives - Military veterans preferred

InComm


Manager I, Fraud - Healthcare & Incentives

US--

Job ID: 2025-16581
Type: Full-Time
# of Openings: 1
Category: Risk & Compliance
InComm Payments

Overview

When you think of InComm Payments, think of Innovative Payments Technology. We were founded over 30 years ago and continue to be a pioneer in the payment (FinTech) industry. Since our inception, we have grown to be a team of over 3,000 employees in 35 countries around the world. We own over 400 global technical patents and a network that includes over 525,000 points of retail distribution that points to our industry expertise.

InComm Payments works with the most recognized and valued brands in the world, and we are partnered with most of the world’s leading merchants. InComm Payments is highly focused on our people and their growth, and we work hard to make a career at InComm Payments meaningful and rewarding. We value innovation, quality, passion, integrity, and responsibility in all that we do, and we are looking for great people to join our team as we move forward towards a very bright future.

You can learn more about InComm Payments by visiting our Website or connecting with us on LinkedIn, YouTube, Twitter, Facebook, or Instagram.

Operational SOP Development & Oversight:

Establish and refine Standard Operating Procedures (SOPs) for fraud risk management within InComm Benefits. Key Deliverables include:

• Develop and document fraud prevention SOPs, ensuring efficiency and scalability across FSA, HSA, and WSA plans.
• Implement case management workflows for plan member fraud investigation and resolution.
• Define fraud intake, triage, and escalation processes to streamline case handling.
• Ensure alignment of operational fraud procedures with overall InComm Benefits strategies.

Compliance & Regulatory Management:

Ensure fraud prevention processes align with healthcare benefits compliance and regulatory requirements. Key Deliverables include:

• Work closely with Compliance & Legal teams to ensure adherence to benefits fraud policies by monitoring state and federal regulations related to FSA, HSA, and WSA fraud prevention.
• Implement audit processes to ensure case management compliance with InComm Benefits requirements.
• Ensure fraud case handling aligns with HIPAA, IRS guidelines, and other regulatory frameworks.

Plan Member Management (Case Manager Integration):

Enhance fraud-related case management processes for plan members, ensuring quick and effective resolution. Key Deliverables include:

• Define and manage plan member fraud cases within Case Manager.
• Develop fraud prevention strategies that minimize misuse of FSA, HSA, and WSA funds.
• Collaborate with customer service teams to provide fraud-related support to plan members

Data Analysis & Reporting:

Leverage data-driven insights to optimize fraud detection and prevention strategies. Key Deliverables include:

• Develop fraud reporting dashboards to monitor fraud risk trends.
• Conduct root cause analysis to identify common fraud patterns among plan members.
• Work with Data Science & Fraud Technology teams to improve fraud scoring models.
• Define and track fraud loss metrics, ensuring continuous monitoring of risk exposure.

Client Support (Product Management Alignment):

Act as the fraud liaison between fraud operations and product management, ensuring fraud prevention is integrated into product design. Key Deliverables include:

• Provide fraud insights to Product Management to improve InComm Benefits solutions.
• Support new fraud prevention features in collaboration with the Product team.
• Assist in defining fraud-related KPIs for InComm Benefits product performance.

Risk Management & Fraud Prevention:

Strengthen risk management frameworks to mitigate fraud risks within InComm Benefits. Key Deliverables:

• Develop risk assessment frameworks for benefits fraud monitoring.
• Implement automated fraud detection strategies to reduce manual investigation time.
• Collaborate with internal security teams to improve fraud case triage.

Cross-Functional Collaboration:

Work with internal and external teams to enhance fraud prevention capabilities across InComm Benefits. Key Deliverables include:

• Collaborate with Fraud Ops, Compliance, Data Science, and Customer Service teams.
• Engage with external fraud networks to share insights and best practices.
• Ensure fraud mitigation efforts are aligned across all InComm Benefits functions.

Fraud Operations & Risk Expertise:

• 5+ years of experience in fraud prevention, financial benefits fraud, or risk management.
• Experience with fraud operations in healthcare benefits (FSA, HSA, WSA preferred).
• Strong knowledge of case management workflows & fraud risk controls.

Data-Driven Fraud Prevention:

• Strong analytical skills, with experience in fraud trend analysis and KPI tracking.
• Proficiency in Excel, SQL, or fraud analytics tools (Tableau, Power BI, etc.).

Compliance & Regulatory Knowledge:

• Experience working within HIPAA, IRS, and FSA/HSA/WSA regulatory frameworks.

Cross-Functional Leadership & Communication:

• Ability to work with Product, Compliance, Fraud Ops, and Client Support teams.
• Strong process improvement and project management skills.

InComm Payments provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity or national origin, citizenship, veteran’s status, age, disability status, genetics or any other category protected by federal, state, or local law.

*This position is eligible for the Employee Referral Bonus Program Tier III #LI-SO1

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