Full Time Insurance Claims - FWA Consultant- Malaysia Jobs, in Infosys Consulting Federal Territory - Maukerja

Insurance Claims / FWA Consultant:

Health insurance focused consulting role for Fraud, Waste & Abuse AI implementation for insurance sector clients.

Key Responsibilities

1. Use Case Shaping & Delivery Planning

• Translate FWA priorities into clear AI delivery requirements, implementation plans, and release roadmaps.
• Partner with Business, data, and technology stakeholders to define the scope, objectives, and success criteria for priority use cases.
• Support prioritization of AI use cases based on business impact, feasibility, data readiness, and operational value.
• Develop delivery plans that account for model development, system integration, governance approvals, and business readiness.
• Ensure use cases are designed for scalability and reusability across markets where appropriate.

1. Business-to-Technology Coordination

• Serve as the key coordination point across business teams, AI teams, engineering, data teams, and platform owners.
• Translate fraud management and investigation into implementable AI, workflow, and system requirements.
• Coordinate data and integration requirements needed to enable FWA use cases, including structured and unstructured data inputs.
• Manage key dependencies across case management systems, data pipelines, alerting platforms, and supporting tools.

1. Testing, Deployment & Business Adoption

• Coordinate UAT and business validation activities for FWA AI solutions, ensuring outputs are practical and fit for Health investigation workflows.
• Ensure testing covers real-world fraud patterns, edge cases, false positive handling, investigator usability, and escalation logic.
• Validate deployment readiness, performance expectations, and integration stability with technical teams.
• Support rollout planning across markets, including pilot execution, adoption support, and stabilization.
• Ensure solutions are embedded with appropriate user guidance, support processes, and feedback mechanisms.

• Key Skills & Experience
• Education Bachelor's or Master's degree in Business, Technology, Data, AI, Analytics, Health Management, or a related field.
• Experience 8+ years' experience in analytics delivery, AI implementation, fraud / risk transformation, or Health technology delivery.
• Delivery experience Proven experience delivering complex data, analytics, or AI solutions from design through deployment.
• Business domain experience Experience in fraud, claims abuse management, investigation operations, payment integrity, or Health risk analytics strongly preferred.
• Stakeholder management Strong experience working with senior Health, business, and technology stakeholders.
• Communication Ability to translate fraud and investigation needs into practical delivery requirements and communicate across technical and non-technical audiences.
• Technology understanding Good understanding of AI and analytics delivery, data pipelines, APIs, workflow integration, and operational tooling.
• Testing & rollout Experience coordinating UAT, pilot rollout, performance monitoring, and post-launch stabilization.
• Program management: Strong planning, dependency management, issue resolution, and governance support capabilities.
• Collaboration Strong cross-functional and cross-geography collaboration skills.

• Domain Expertise Preferred Health Fraud, Waste, and Abuse management.
• Claims fraud detection and investigation support.
• Anomaly detection and risk scoring use cases.
• Investigator workflow optimization.
• Human-in-the-loop AI support models. Attributes That Will Help You Succeed
• Practical and delivery-focused, with strong execution discipline.
• Comfortable operating in high-scrutiny, risk-sensitive environments.
• Strong at bridging Health business needs with technical delivery.
• Structured, analytical, and calm under pressure.