Manager, Fraud Operations (Remote)

Availity delivers revenue cycle and related business solutions for health care professionals who want to build healthy, thriving organizations. Availity has the powerful tools, actionable insights and expansive network reach that medical businesses need to get an edge in an industry constantly redefined by change.

At Availity, we're not just another Healthcare Technology company; we're pioneers reshaping the future of healthcare! With our headquarters in vibrant Jacksonville, FL, and an exciting office in Bangalore, India, along with an exceptional remote workforce across the United States, we're a global team united by a powerful mission.
We're on a mission to bring the focus back to what truly matters – patient care. As the leading healthcare engagement platform, we're the heartbeat of an industry that impacts millions. With over 2 million providers connected to health plans, and processing over 13 billion transactions annually, our influence is continually expanding.
Join our energetic, dynamic, and forward-thinking team where your ideas are celebrated, innovation is encouraged, and every contribution counts. We're transforming the healthcare landscape, solving communication challenges, and creating connections that empower the nation's premier healthcare ecosystem.

The Manager of Fraud Operations will be responsible for developing, executing, and optimizing fraud detection and prevention strategies within the Availity platform. This role is critical in maintaining the integrity of our services, reducing fraud-related risks, and ensuring a seamless customer experience. The ideal candidate will have deep understanding in fraud management, operations leadership, and a passion for leveraging data and technology to combat fraud at scale.

Sponsorship, in any form, is not available for this position.

Location: Remote, US

Role qualifications:

• Bachelor's degree in Business, Finance, Information Security, or related field. Master’s degree preferred. Possesses a bachelor’s degree in Computer Science, Computer Engineering, or equivalent
• Minimum of 5 years of experience in fraud prevention and risk management, with at least 3 years in a leadership role.
• Strong experience in SaaS business environments is highly preferred.
• In-depth knowledge of fraud detection tools, technologies, and platforms (e.g., machine learning, artificial intelligence, behavioral analytics).
• Proven track record of managing fraud risk across multiple channels (e.g., payment fraud, account takeover, subscription abuse).
• Excellent analytical and problem-solving skills with the ability to assess complex situations and make data-driven decisions.
• Strong leadership and team management abilities, with experience building and scaling teams.
• Expertise in fraud analytics, incident response, and the use of fraud detection platforms.
• Familiarity with relevant regulatory frameworks, such as GDPR, PCI DSS, and SOC 2, and their impact on fraud operations.
• Strong communication skills, with the ability to present complex ideas clearly to both technical and non-technical stakeholders.
• Ability to thrive in a fast-paced, dynamic environment.

What you will be doing:

Fraud Strategy Development

• Design and implement fraud detection and prevention strategies tailored to our business models.
• Define and track key fraud metrics and KPIs to monitor the effectiveness of fraud operations.
• Lead initiatives to continuously improve fraud prevention processes, identifying emerging fraud trends and proactively addressing vulnerabilities.

Team Leadership & Management

• Lead, mentor, and develop a high-performing fraud operations team, providing guidance, training, and support to team members.
• Oversee daily operations of fraud monitoring, investigation, and escalation processes to ensure efficient and effective fraud resolution.
• Foster collaboration across teams (engineering, product, customer support) to address fraud-related challenges.

Data-Driven Decision Making

• Analyze fraud data, identify trends, and leverage data analytics tools to optimize fraud detection systems.
• Work closely with data science and engineering teams to enhance machine learning models and fraud detection algorithms.
• Use both historical data and predictive analytics to anticipate potential fraud threats and mitigate risk.

Collaboration & Stakeholder Management

• Partner with cross-functional teams, including legal, compliance, product, and customer support, to ensure a cohesive approach to fraud prevention.
• Communicate fraud risk and incident reports to senior leadership and other stakeholders, providing actionable insights and recommendations.
• Liaise with external fraud prevention partners, including payment processors, and industry experts, to stay up to date on best practices and trends.

Incident Response & Investigation

• Lead investigations into suspected fraudulent activities, ensuring timely resolution and appropriate action.
• Develop and enforce standardized processes for investigating and responding to fraud incidents.
• Ensure compliance with relevant laws, regulations, and industry standards related to fraud prevention and data protection.

Continuous Improvement & Innovation

• Stay up to date on the latest fraud trends, tools, and technologies to ensure the company is using cutting-edge methods to combat fraud.
• Develop and promote a culture of continuous improvement within the fraud operations team, focusing on innovation and adapting to new fraud threats.

Availity culture and benefits:

• Availity is a certified “Great Place to Work”, a “Best Workplaces for Technology Companies”, a “Best Workplaces for Women” and a “Best Workplaces for Millennials”!
• Culture is important to us and there are many ways for you to make your mark here!
• We have several Diversity & Inclusion teams and various ways to engage with fellow Availity associates. “AvaiLadies”, “Beyond Black”, “HOLA”, “Availity Pride”, “VetAvaility” a Young Professionals Group and “She Can Code IT” a group for women in tech are some of the groups you can get involved in.
• Availity is a culture of continuous learning. We have many resources and experts in our tech stack and in our industry that can help get you there too!
• We offer a competitive salary, bonus structure, generous HSA company contribution, healthcare, vision, dental benefits and a 401k match program that you can take advantage of on day one!
• We offer unlimited PTO for salaried associates + 9 paid holidays. Hourly associates start at 19 days of PTO and go up from there with all the same holiday benefits.
• Interested in wellness? We allow our associates to reimburse up to $250/year for gym memberships, participation in racing events, weight management programs, etc.
• Interested in furthering your education? We offer education reimbursement!
• Availity offers Paid Parental Leave for both moms and dads, both birth parents and adoptive parents.
• Want to work for an organization that gives back to the community? You’re at the right place! Availity partners with various organizations, both locally and nationally, to raise awareness, funds and morale as our staff members volunteer their time and funds to engage the organizations campaign.

Next steps:

After you apply, you will receive text/email messages thanking you for applying and then you will continue to receive more text/email messages alerting you as to where you are in the recruitment process.

Interview process:

• Recruiter resume review 
• Manager resume review 
• Recruiter video interview
• Manager video interview
• Panel video interview

Availity is an equal opportunity employer and makes decisions in employment matters without regard to race, religious creed, color, age, sex, sexual orientation, gender identity, gender expression, genetic information, national origin, religion, marital status, medical condition, disability, military service, pregnancy, childbirth and related medical conditions, or any other classification protected by federal, state, and local laws and ordinances.

Availity is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

NOTICE: Federal law requires all employers to verify the identity and employment eligibility of all persons hired to work in the United States. When required by state law or federal regulation, Availity uses I-9, Employment Eligibility Verification in conjunction with E-Verify to determine employment eligibility. Learn more about E-Verify at http://www.dhs.gov/e-verify.

Click the links below to view Federal Employment Notices.

Family & Medical Leave Act  Equal Employment Law Poster  Pay Transparency  Employee Polygraph Protection Act  IER Right to Work Poster  Important Notice about Employee Rights to Organize and Bargain Collectively with Their Employers