Healthcare Program Integrity Analyst

Key Role:

Collaborate with a team focused on supporting federal healthcare clients in program integrity initiatives. Research and analyze specific requirements and policies regarding program integrity and fraud, waste, and abuse. Review and analyze federal and state regulations, evaluate their effects on existing operations, and provide recommendations to maintain operational compliance with governmental regulations and industry requirements. Identify opportunities and implement procedures to drive operational efficiencies, emphasizing cost containment, quality, compliance, and accuracy. Provide client-ready project documentation to supervisors and management. Define healthcare improvement and tactical strategies. Lead defined project work streams and apply knowledge of commonly used healthcare concepts, practices, and procedures.

Basic Qualifications:

-6+ years of experience with Health and Human Services (HHS) program integrity and identifying, investigating, reporting, and resolving instances of healthcare fraud, waste, and abuse

-4+ years of experience with task, project, and team management

-4+ years of experience with basic data analysis required

-Experience with Microsoft Office at an advanced level

-Ability to analyze a variety of sources to uncover issues and form recommendations

-Ability to function independently, collaborate in a team environment, and manage teams

-BA or BS degree in Healthcare Administration or Accounting

Additional Qualifications:

-4+ years of experience with advanced data analysis preferred

-4+ years of experience with Medicaid eligibility

-Experience with general management consulting

-Experience with interviewing stakeholders and working with law enforcement a plus

-Possession of excellent oral and written communication skills

-MA or MS degree in Health Policy or Health Management a plus

-CFE, AHFI, or CHC Certifications preferred

We’re an EOE that empowers our people—no matter their race, color, religion, sex, gender identity, sexual orientation, national origin, disability, veteran status, or other protected characteristic—to fearlessly drive change.

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