Senior SIU Analyst - FWA Detection

Our client, in healthcare analytics domain is seeking a Senior SIU Analyst - FWA Detection to join their team. As a Senior SIU Analyst, you will be part of the Investigations department supporting FWA detection validation and product development. The ideal candidate will have a strong investigative mindset, the ability to translate complex billing patterns into clear findings, and the drive to validate whether detection signals are truly actionable.

Job Title: Senior SIU Analyst - FWA Detection

Location: Bowie, Maryland

Pay Range: $62-65/hr depending on years of experience

What's the Job?

• Validate whether the FWA detection approach surfaces real, actionable fraud/waste/abuse signals and produce substantiated findings to support FWA product development.
• Review claims flagged by detection logic and determine true positive vs. false positive outcomes.
• Articulate the specific billing pattern, code combination, or provider behavior driving each flagged call.
• Carry select flagged leads through to a documented, substantiated finding.
• Partner with product and data science teams to translate investigative judgment into refined detection rules.
  
  
  

What's Needed?

• 4 years of FWA investigative experience, with payer-side experience preferred.
• Direct exposure to claims coding logic, including CPT/HCPCS, ICD-10, and DRG/APC.
• Prior experience starting cold on a live data feed.
• Comfort working from partial or imperfect data (e.g., sample extracts rather than a finished production system).
• SQL or equivalent self-serve query ability, plus familiarity with edit/rules logic (e.g., NCCI edits).
  
  
  

What's in it for me?

• Opportunity to validate and improve FWA detection signals that directly inform product development.
• Collaboration with product and data science teams to refine detection rules using real investigative findings.
• Clear performance focus on substantiation-rate and findings-volume targets (set once the POC window and initial data are confirmed).
• Experience producing findings/recommendation memos that help stakeholders decide whether to scale, iterate, or stop an approach.
• Visibility of your work through presentations of findings to non-investigator audiences, including product, compliance, and leadership.
  
  
  

Upon Completion Of Waiting Period Consultants Are Eligible For

• Medical and Prescription Drug Plans
• Dental Plan
• Vision Plan
• Health Savings Account
• Health Flexible Spending Account
• Dependent Care Flexible Spending Account
• Supplemental Life Insurance
• Short Term and Long Term Disability Insurance
• Business Travel Insurance
• 401(k), Plus Match
• Weekly Pay
  
  
  

If this is a role that interests you and you'd like to learn more, click apply now and a recruiter will be in touch with you to discuss this great opportunity. We look forward to speaking with you!

About ManpowerGroup, Parent Company of: Manpower, Experis, Talent Solutions, and Jefferson Wells.

ManpowerGroup® (NYSE: MAN), the leading global workforce solutions company, helps organizations transform in a fast-changing world of work by sourcing, assessing, developing, and managing the talent that enables them to win. We develop innovative solutions for hundreds of thousands of organizations every year, providing them with skilled talent while finding meaningful, sustainable employment for millions of people across a wide range of industries and skills. Our expert family of brands – Manpower, Experis, Talent Solutions, and Jefferson Wells – creates substantial value for candidates and clients across more than 75 countries and territories and has done so for over 70 years. We are recognized consistently for our diversity - as a best place to work for Women, Inclusion, Equality and Disability and in 2023 ManpowerGroup was named one of the World's Most Ethical Companies for the 14th year - all confirming our position as the brand of choice for in-demand talent.