Medicaid & Medicare Fraud Detection SME
General Dynamics Information Technology•USA MD Home Office (MDHOME), MD
•$148,750 - $201,250•Remote
About The Position
As a Functional Analyst SME, the work you’ll do at GDIT will be impactful to the mission of the Centers for Medicare and Medicaid Services (CMS). You will play a crucial role in leading teams through complex analyses and tool development to detect and prevent fraud, waste, and abuse (FWA) in the Medicare programs.
Requirements
- Bachelor of Arts/Bachelor of Science and at least 15 years of experience in Medicare/Medicaid
- Deep knowledge of U.S. healthcare system including Medicare and Medicaid with an expertise in analyzing healthcare claims data for the use of fraud detection
- Ability to obtain/maintain a Public Trust
Nice To Haves
- Collaboration
- Deliverables Management
- Fraud Detection
- Fraud Investigations
Responsibilities
- Manage fraud detection projects from concept to completion, ensuring they meet strategic objectives and include actionable results to detect and deter FWA
- Guide teams in the completion of tasks including nurturing junior level team members through claims data analysis, interpretation of policy, and conducting of advanced statistical analysis
- Partner with subject matter experts and other team members to deliver quality findings and actionable recommendations
- Present complex analytics and insights in a comprehensible manner to a range of audiences (technical/non-technical) and to various levels of leadership
- Build and maintain client relationships
- Identify opportunities for leveraging Medicare and Medicaid data to drive insightful FWA solutions
- Effectively communicate with team members while working remotely
- Perform additional duties as assigned
Benefits
- Medical plan options
- Health Savings Accounts
- Dental plan options
- Vision plan
- 401(k) plan with company match
- Full flex work weeks
- Paid time off plans (vacation, sick, personal time)
- 10 paid holidays per year
- Paid parental leave
- Military leave
- Bereavement leave
- Jury duty leave
- Paid Family Leave program
- Short-term disability benefits
- Long-term disability benefits
- Life insurance
- Accidental death and dismemberment insurance
- Personal accident insurance
- Critical illness insurance
- Business travel and accident insurance
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What This Job Offers
Job Type
Full-time
Career Level
Senior
