(764) Fraud Risk Assessment Consultant

Position Description:

Arlo Solutions is supporting the Department of Veterans Affairs (VA) Veterans Health Administration (VHA) Office of Integrity and Compliance (OIC) in standing up and running the VHA Fraud Rapid Response Center ("VA War Room"). The War Room protects Veterans and taxpayer dollars through data analytics, fraud risk assessment and fast administrative action. The Fraud Risk Assessment Consultant supports the continuation and expansion of fraud risk assessment, monitoring and program compliance review activities. This person applies fraud risk management expertise to identify, assess, document and prioritize fraud vulnerabilities and risks, and supports the development of risk mitigation strategies and internal control enhancements. The consultant conducts research and analysis, facilitates stakeholder engagement, evaluates program processes and existing controls, and synthesizes information from interviews, data, documentation and other sources to identify fraud exposures. This person supports the assessment of inherent and residual risk and helps translate identified vulnerabilities into actionable fraud prevention, monitoring and risk mitigation activities. The consultant follows established fraud risk management methodologies and procedures, and supports consistent documentation, quality assurance, reporting and integration of assessment results into broader enterprise risk management (ERM) activities. The role is advisory and analytical. All final decisions stay with Government personnel.

Location:  REMOTE

Clearance:  Public Trust

Responsibilities and/or Success Factors:

• Fraud Risk Assessments:
  • Identify, assess, document and prioritize fraud vulnerabilities and risks in VHA programs.
  • Assess inherent and residual risk using established methodologies such as the GAO Fraud Risk Framework.
  • ndependently complete assessment assignments as tasked by OIC.
    
    
    
• Internal Controls Assessment:
  • Evaluate program processes and existing controls.
  • Support control testing and develop recommendations to strengthen internal controls.
    
    
• Root Cause Analysis & Remediation:
  • Support root cause analysis of identified vulnerabilities and help turn them into actionable prevention, monitoring and mitigation plans.
    
    
• Research & Synthesis:
  • Gather and analyze information from stakeholder interviews, data, program documentation and other sources to identify fraud exposures.
    
    
• Stakeholder Engagement:
  • Facilitate interviews, working sessions and meetings with OIC, ERM staff and VHA program stakeholders.
    
    
• Risk Governance & Reporting:
  • Support risk governance activities and help develop dashboards, reports and visualizations of VHA risk data on OIC-designated platforms.
    
    
    
• Documentation & Quality Assurance:
  • Keep assessment documentation consistent and complete, follow QA procedures, and help integrate results into broader ERM activities.
    
    
    
• Continuous Improvement & Knowledge Transfer:
  • Contribute to training materials, prevention recommendations, kaizen sessions and after-action debriefs so VA staff can sustain the work on their own.
    
    

• Ad Hoc Reporting:
  • Support short-turnaround white papers, summaries and briefings for VA leadership as requested.

Minimum Qualifications Including Certificates:

• Able to pass a Tier 2 / Moderate Background Investigation (MBI) and get a VA PIV card
• Bachelor's degree 
• 3-5+ years of relevant fraud experience, such as fraud risk assessments, fraud risk management, internal controls, program compliance review or FWA work
• Working knowledge of fraud risk management and internal control frameworks: the GAO Fraud Risk Framework, COSO Enterprise Risk Management and Internal Control frameworks, and the GAO Standards for Internal Control in the Federal Government (Green Book)
• Experience assessing inherent and residual risk and documenting control evaluations
• Strong research, analysis and synthesis skills, with the ability to draw conclusions from interviews, data and documentation
• Strong written and verbal communication skills, including facilitating stakeholder meetings and interviews 
• Able to handle PHI and sensitive information under HIPAA and VA privacy requirements, and to complete the required VA TMS trainings
• Must be legally eligible to work in the United States

Desired Qualifications:

• Healthcare fraud experience (strongly preferred), especially healthcare claims and payment integrity
• Experience with federal healthcare programs such as VA/VHA, CMS, Medicare or Medicaid Federal program experience Enterprise risk management experience
• Knowledge of fraud schemes and investigative concepts
• Familiarity with federal fraud and payment integrity requirements, such as the Payment Integrity Act of 2019, OMB Circular A-123 and FMFIA
• Certified Fraud Examiner (CFE) or a related certification (CIA, CRMA or CGFM)