Fraud Model Developer in United States

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Lead, Senior Decision Scientist serves as a strategic analytics and ideation leader supporting Payment Integrity Affordability initiatives with a primary focus on Fraud, Waste & Error (FWE) and Special Investigations Unit (SIU) programs. This role provides leadership and guidance to a team of Decision Scientists while driving the development, evaluation, and implementation of innovative opportunities that improve affordability outcomes and strengthen Payment Integrity capabilities. The Lead Decision Scientist is responsible for establishing analytical frameworks, managing ideation pipelines, defining success metrics, and identifying cross-functional opportunities that create enterprise value across Payment Integrity programs. Required Qualifications 7+ years of experience in healthcare analytics, Payment Integrity, Fraud, Waste & Error (FWE), Special Investigations, or related healthcare operations. 5+ years of experience leading analytical projects or providing technical leadership within a healthcare environment. Demonstrated experience working with healthcare claims platforms including ACAS, QNXT, HRP, or comparable systems. Experience using SAS, SQL, Python, R, or other analytical and statistical programming languages. Experience performing advanced data analysis, opportunity identification, trend analy

Replit is the agentic software creation platform that enables anyone to build applications using natural language. With millions of users worldwide, Replit is democratizing software development by removing traditional barriers to application creation. About the Role We're redefining how software is built and who gets to build it. Our mission is to achieve Autonomy for All: making programming accessible, collaborative, and powered by AI. Realizing that vision requires a platform that legitimate users can trust and adversarial actors cannot exploit. We're hiring a Data Scientist to help build Replit's Trust & Safety and Anti-Abuse program from the ground up. You'll turn noisy behavioral, identity, payment, infrastructure, and content signals into the measurement systems, detections, and decisions that protect Replit's users, platform, and economics. You'll work closely with Engineering, Support, Legal, Security, Infrastructure, Money, and Growth to make abuse economically unviable while keeping friction low for legitimate users. Replit sits at the frontier of AI-native abuse. Our platform is a target for phishing and scam hosting, cryptomining, LLM token farming, card and coupon fraud, referral abuse, and increasingly, abuse driven by AI agents themselves. You'll help define how we identify, measure, and respond to these threats without compromising the experience of good users. Who You Are You're a data scientist who moves fast, goes deep, and thinks adversarially. You can spin up an analysis in hours that would take others days, not by cutting corners, but because you've built the intuition and technical toolkit to get to the right answer quickly. You dig past the top-line abuse rate to understand selection effects, missing labels, policy changes, attacker adaptation, and the false positives hidden inside an aggregate metric. You understand that Trust & Safety data is imperfect and outcomes are high stakes. Ground truth is delayed, biased, and often incomple

Every day, tens of millions of people come to Roblox to explore, create, play, learn, and connect with friends in 3D immersive digital experiences– all created by our global community of developers and creators. At Roblox, we’re building the tools and platform that empower our community to bring any experience that they can imagine to life. Our vision is to reimagine the way people come together, from anywhere in the world, and on any device. We’re on a mission to connect a billion people with optimism and civility, and looking for amazing talent to help us get there. A career at Roblox means you’ll be working to shape the future of human interaction, solving unique technical challenges at scale, and helping to create safer, more civil shared experiences for everyone. WHY DATA SCIENCE & ANALYTICS? The Data Science & Analytics organization's mission is to increase our speed, frequency and acumen of making decisions at scale by instilling a data-influenced approach to building products. We cover a wide area of the data spectrum including analytical data engineering, product analytics, experimentation, causal inference, statistical modeling and machine learning. Aligned and partnering with product verticals, we use this extensive tool belt to discover new opportunities and unmet use cases, influence and shape the product roadmap and prioritization, build data products and measure impact on our community of players and developers. WHY AUTHENTICATION & SECURITY? Authentication & Security sits at the intersection of trust, product, and growth. The team builds the systems that allow users to sign in, recover, and protect their accounts with confidence, while defending the platform against account takeovers, credential abuse, and fraud at massive scale. This role is an opportunity to shape a high-stakes product area where small changes in friction or protection can meaningfully affect sign-ups and user frequency. You will act as a strategic leade

About the Team At OpenAI, our User Safety & Risk Operations (USRO) team helps protect our products and users from abuse, fraud, safety risks, and other forms of misuse. We translate real-world user and operational signals into timely decisions, practical interventions, and improvements to our products and systems. This role will take on new, ambiguous, or underdeveloped operational risks and help mature them into scalable capabilities. We work across USRO and partner closely with Product, Engineering, Data Science, Product Policy, Legal, Safety, Support, and external vendors or partnership stakeholders. About the Role We are seeking a Senior Operations Analyst to take on complex, ambiguous safety and risk problems and turn them into practical operational solutions that can scale. This is a senior individual-contributor role for a versatile operator who is comfortable moving between queues, investigation, analysis, workflow design, hands-on execution, and cross-functional leadership. Depending on team needs, the role may focus on emerging-risk incubation, cloud deployment partnerships, or other new operational areas. You will be expected to move quickly, work hands-on, and create structure without waiting for perfect requirements or a large support team. The work starts with the problem, not a prescribed process. You may investigate unstructured user signals, stand up a lightweight workflow, build an AI-assisted tool, improve an existing operation, or help a new launch become operationally ready. The goal is to produce durable systems that other people can run, not simply complete a series of individual tasks. The portfolio will change with company priorities and may span established harm areas, emerging-risk incubation, cloud deployments and partnerships, device safety, or new product launches. Some hires may focus primarily on cloud deployment operations, including launch readiness, partner coordination, safety workflows, and operational monitoring. You will ty

Our Purpose Mastercard powers economies and empowers people in 200+ countries and territories worldwide. Together with our customers, we’re helping build a sustainable economy where everyone can prosper. We support a wide range of digital payments choices, making transactions secure, simple, smart and accessible. Our technology and innovation, partnerships and networks combine to deliver a unique set of products and services that help people, businesses and governments realize their greatest potential. Title and Summary Manager, Partner Success – Security Solutions Overview Mastercard Services leverages the company’s unique data, analytics, technology, and expertise to help customers grow, optimize performance, and manage risk. It delivers solutions across areas like fraud and cybersecurity, customer acquisition and engagement, open finance, and business insights—making commerce smarter, safer, and more personalized through data‑driven products and advisory capabilities. One of our strategic objectives is to diversify our revenue via new distribution pathways, including through Partners. As such, we are increasing our focus around Partner Success to support the growth of both our partner and MA revenue. We are seeking an experienced Partner Success Manager to effectively manage a portfolio of strategic B2B partners who utilize multiple Mastercard services products or solutions to mitigate risk and prevent fraud. The Partner Success Manager will support partners throughout the onboarding process, provide ongoing relationship management, and drive revenue growth through expansions and strategic initiatives. This individual will serve as a partner advocate within a matrixed organization. The Role 1. Performance, Insights & Governance Monitor partner performance, product adoption, usage, satisfaction, se

Starting Hourly Rate / Salario por Hora Inicial: $19.00 USD per hour ALL ABOUT TARGET Working at Target means helping all families discover the joy of everyday life. We bring that vision to life through our values and culture. Learn more about Target here. ALL ABOUT ASSETS PROTECTION Assets Protection ( AP ) teams function to keep our guests, team and brand secure and lead through crisis events. They protect profitable sales by mitigating shortage risks, preventing, and resolving theft and fraud to ensure product is available for our guest . They also build relationships inside and outside of Target , including store leaders and public safety officials, inclusive of law enforcement. At Target , we believe in our team members having meaningful experiences that help them build and develop skills for a career. The role of a Target Security Specialist can provide you with the skills and experience of : <sp

Starting Hourly Rate / Salario por Hora Inicial: $18.50 USD per hour ALL ABOUT TARGET Working at Target means helping all families discover the joy of everyday life. We bring that vision to life through our values and culture. Learn more about Target here. ALL ABOUT ASSETS PROTECTION Assets Protection ( AP ) teams function to keep our guests, team and brand secure and lead through crisis events. They protect profitable sales by mitigating shortage risks, preventing, and resolving theft and fraud to ensure product is available for our guest . They also build relationships inside and outside of Target , including store leaders and public safety officials, inclusive of law enforcement. At Target , we believe in our team members having meaningful experiences that help them build and develop skills for a career. The role of a Target Security Specialist can provide you with the skills and experience of : <sp

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Fraud, Waste, and Abuse (FWA) Analyst II identifies and develops potential healthcare fraud leads through data mining, claims analysis, and investigative research. As a key contributor to the SIU lead development process, this role evaluates provider, member, pharmacy, and ancillary healthcare billing patterns for signs of fraud, waste, abuse, and other anomalies. The Analyst II uses internal claims data, analytical tools, business rule results, and industry intelligence to assess potential FWA concerns and determine whether they warrant formal investigation. This role requires strong analytical skills, healthcare claims expertise, and the ability to translate complex data into actionable investigative leads and recommendations. Essential Responsibilities Lead Development & Fraud Detection Develop proactive and reactive leads to identify potential fraud, waste, and abuse. Generate FWA leads by mining claims databases, reporting tools, and investigative systems. Validate and refine leads generated by business rules to assess their credibility and investigative value. Examine spike analyses, utilization trends, payment anomalies, and outlier reports for unusual billing patterns. Evaluate provider, member, pharmacy, DME, transportation, and facility billing for indicators of fraud or abuse. Moni

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Fraud, Waste, and Abuse (FWA) Analyst II identifies and develops potential healthcare fraud leads through data mining, claims analysis, and investigative research. As a key contributor to the SIU lead development process, this role evaluates provider, member, pharmacy, and ancillary healthcare billing patterns for signs of fraud, waste, abuse, and other anomalies. The Analyst II uses internal claims data, analytical tools, business rule results, and industry intelligence to assess potential FWA concerns and determine whether they warrant formal investigation. This role requires strong analytical skills, healthcare claims expertise, and the ability to translate complex data into actionable investigative leads and recommendations. Essential Responsibilities Lead Development & Fraud Detection Develop proactive and reactive leads to identify potential fraud, waste, and abuse. Generate FWA leads by mining claims databases, reporting tools, and investigative systems. Validate and refine leads generated by business rules to assess their credibility and investigative value. Examine spike analyses, utilization trends, payment anomalies, and outlier reports for unusual billing patterns. Evaluate provider, member, pharmacy, DME, transportation, and facility billing for indicators of fraud or abuse. Moni

Our Purpose Mastercard powers economies and empowers people in 200&#43; countries and territories worldwide. Together with our customers, we’re helping build a sustainable economy where everyone can prosper. We support a wide range of digital payments choices, making transactions secure, simple, smart and accessible. Our technology and innovation, partnerships and networks combine to deliver a unique set of products and services that help people, businesses and governments realize their greatest potential. Title and Summary Senior Specialist, Product Management - GTM and Enablement Services within Mastercard is responsible for acquiring, engaging, and retaining customers by managing fraud and risk, enhancing cybersecurity, and improving the digital payments experience. We provide value-added services and leverage expertise, data-driven insights, and execution. Overview This Senior Specialist, Product Management will support the commercialization and sales expansion of Operational Intelligence products across one of the five global regions. The role will focus on driving product adoption, identifying customer pain points, supporting sales enablement, and contributing to the development of commercialization strategies. The individual will work closely with regional Advisors & Consulting Services(AC&S) teams and the Global Product Management team to ensure alignment between product capabilities and market needs. The Role •Collaborate with AC&S organization to support product commercialization efforts and drive customer engagement •Assist in identifying short-term and long-term whitespace opportunities and new use cases based on customer feedback and market trends •Support internal and external partnership initiatives to accelerate go-to-market efforts •Contribute to pricing strategy discussions

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Waste & Error Certified Coding Manager is responsible for leading the Certified Coding Analyst and W&E Team Lead roles that conduct medical claim reviews and coding audits to identify billing errors, waste, abuse, fraud, and payment integrity opportunities. The Manager provides direct people leadership, establishes operational priorities, ensures consistent application of coding and billing requirements, and is accountable for team productivity, quality, service levels, compliance, and employee development. This role partners closely with the W&E team lead, who provides day-to-day technical guidance and subject matter support to the coding team. The Manager retains accountability for staffing, performance management, workload oversight, escalations, audit readiness, process improvement, and delivery of business outcomes. The position also represents the team in discussions with senior leadership, Medical Directors, Legal, Compliance, Analytics, Operations, and other Payment Integrity partners. Primary Responsibilities People Leadership & Team Development Lead, coach, and develop a team of Certified Coding Analysts and Senior Certified Coding Analysts. Establish clear role expectations, performance goals, productivity standards, quality requirements, and accountability measures. Conduct regular perfor

Our Purpose Mastercard powers economies and empowers people in 200&#43; countries and territories worldwide. Together with our customers, we’re helping build a sustainable economy where everyone can prosper. We support a wide range of digital payments choices, making transactions secure, simple, smart and accessible. Our technology and innovation, partnerships and networks combine to deliver a unique set of products and services that help people, businesses and governments realize their greatest potential. Title and Summary Manager Marketing Services – Advisors & Consulting Services Services within Mastercard is responsible for acquiring, engaging, and retaining customers by managing fraud and risk, enhancing cybersecurity, and improving the digital payments experience. We provide value-added services and leverage expertise, data-driven insights, and execution. Our Advisors & Consulting Services team combines traditional management consulting with Mastercard’s rich data assets, proprietary platforms, and technologies to provide clients with powerful strategic insights and recommendations. Our teams work with a diverse global customer base across industries, from banking and payments to retail and restaurants. The Advisors & Consulting Services group has five specializations: Strategy & Transformation, Performance Analytics, Business Experimentation, Marketing, and Program Management. Our Marketing consultants lead the strategy development and implementation of campaigns and engagements for clients. They use customer data to provide deep direct marketing expertise across channels, evaluating campaign results and adapting the approach to optimize marketing performance. Positions for different specializations and levels are available in separate job postings. Please review our consulting specializations to learn more

At Snowflake, we are powering the era of the agentic enterprise. To usher in this new era, we seek AI-native thinkers across every function who are energized by the opportunity to reinvent how they work. You don’t just use tools; you possess an innate curiosity, treating AI as a high-trust collaborator that is core to how you solve problems and accelerate your impact. We look for low-ego individuals who thrive in dynamic and fast-moving environments and move with an experimental mindset — who rapidly test emerging capabilities to discover simpler, more powerful ways to deliver results. At Snowflake, your role isn't just to execute a function, but to help redefine the future of how work gets done. We are hiring a Senior Software Engineer for our Anti-Abuse team within Security Foundations. This team is responsible for protecting Snowflake and our customers from abuse on the Snowflake platform — building foundational security primitives across a complex multi-cloud environment to combat fraud, account takeovers, data exfiltration, and AI security threats at the scale of Snowflake’s hyper-growth. AS A SENIOR SOFTWARE ENGINEER, SECURITY FOUNDATIONS AT SNOWFLAKE, YOU WILL: Design, build, and scale security-by-default capabilities that protect Snowflake products across a complex multi-cloud environment Develop intelligent security platforms and services that leverage AI/ML and risk scoring to identify, prioritize, and respond to security threats and policy violations Build real-time detection and prevention systems to defend against account compromise, AI abuse, and data exfiltration through adaptive enforcement and granular policy controls Create security intelligence and monitoring capabilities that detect suspicious account & user activity, generate actionable insights, and enable timely response Partner across Security, Engineering, and Product teams to define security strategy, influence product design, and drive adoption of secure engineering practices Raise the

Starting Hourly Rate / Salario por Hora Inicial: $20.00 USD per hour ALL ABOUT TARGET Working at Target means helping all families discover the joy of everyday life. We bring that vision to life through our values and culture. Learn more about Target here. ALL ABOUT ASSETS PROTECTION Assets Protection ( AP ) teams function to keep our guests, team and brand secure and lead through crisis events. They protect profitable sales by mitigating shortage risks, preventing, and resolving theft and fraud to ensure product is available for our guest . They also build relationships inside and outside of Target , including store leaders and public safety officials, inclusive of law enforcement. At Target , we believe in our team members having meaningful experiences that help them build and develop skills for a career. The role of a Target Security Specialist can provide you with the skills and experience of : <sp

Starting Hourly Rate / Salario por Hora Inicial: $21.00 USD per hour ALL ABOUT TARGET Working at Target means helping all families discover the joy of everyday life. We bring that vision to life through our values and culture. Learn more about Target here. ALL ABOUT ASSETS PROTECTION Assets Protection ( AP ) teams function to keep our guests, team and brand secure and lead through crisis events. They protect profitable sales by mitigating shortage risks, preventing, and resolving theft and fraud to ensure product is available for our guest . They also build relationships inside and outside of Target , including store leaders and public safety officials, inclusive of law enforcement. At Target , we believe in our team members having meaningful experiences that help them build and develop skills for a career. The role of a Target Security Specialist can provide you with the skills and experience of : <sp