Prevention & Control Specialist

Job Summary

At SafeRide Health, we ensure that transportation is never a barrier to care. As a Prevention and Control Specialist, you will play a critical role in protecting the integrity of our transportation benefit program. You'll monitor ride activity to identify potential instances of fraud, waste, or abuse, and analyze data to detect emerging patterns or trends. This role involves conducting proactive outreach, documenting findings with precision, and collaborating with internal teams to strengthen safeguards that ensure members who genuinely need transportation can continue to access their care without disruption.

Your work helps uphold trust in our mission-making healthcare access equitable, efficient, and secure for every member we serve.

Key Responsibilities

Fraud Prevention

• Conduct Facility Outreach: Contact healthcare facilities to verify past and upcoming member rides or claims, ensuring trip accuracy and compliance.
• Investigate Potential Fraud: Identify and assess transportation provider fraud by utilizing SafeRide's Jira fraud-tip system. Review employee-submitted reports of suspicious activity, perform detailed investigations, document findings, and escalate cases as appropriate.
• Flag Mitigation: Flag members or cancel rides confirmed as fraudulent, ensuring prompt action and adherence to company policies.
• Trend and Case Reporting: Monitor for emerging fraud patterns and high-profile cases and proactively communicate findings to management for further review and process improvement.

Data, Tools & Reporting

• Date Management: Utilize Excel to organize, track, and maintain ride verification and fraud investigation data with accuracy and consistency.
• Reporting & Analytics: Leverage Amazon QuickSight to generate, analyze, and interpret reports that support fraud detection, operational insights, and performance tracking.

Partnership & Network Support

• Coordinate with internal teams (e.g., Member Services) to match recurring ride patterns to efficient scheduling paths and reduce service gaps.

Required Qualifications

• High school diploma or equivalent.

• 1+ year in customer service or healthcare operations

• Strong written and verbal communication; confident on the phone with external partners.

• Comfortable learning and using operational technical systems (i.e., QuickSIght), dashboards, and spreadsheets.

• Organized, detail-oriented, and calm under pressure; able to follow structured workflows and escalate appropriately.

• Familiarity with Medicaid/Medicare or healthcare operations.

• Open to travel 10% of the time.

Preferred Qualifications

• Proficient in data entry, record-keeping, and case documentation systems (e.g., QuickSight, Excel, or similar tools). Bilingual proficiency (e.g., English/Spanish).

SafeRide Summary

SafeRide Health is a technology and services company dedicated to reducing barriers to care by improving the delivery of non-emergency medical transportation to people across America. SafeRide employs proprietary technology, paired with a nationwide network of vetted transportation providers. This enables payers and health systems to intelligently deliver cost-effective, on-demand transportation, enhancing the patient's experience in the process. SafeRide serves the largest Medicare Advantage, Medicaid, and provider programs in the country. Learn more at www.saferidehealth.com.