Leading efforts of technical tasks to completion independently and as part of a team. Leading efforts to analyze claims data and reviews Federal and State Medicaid law, regulation, and policy.
Responsibilities:
— Lead technical tasks independently and collaboratively.
— Analyze claims data and review Federal and State Medicaid laws, regulations, and policies.
— Develop data-driven solutions for complex business challenges.
— Collaborate with predictive modeling teams to enhance customer experiences, efficiencies, and process improvements.
— Identify opportunities to leverage Medicare and Medicaid data for insightful business solutions.
— Present findings to diverse audiences including technical and non-technical stakeholders and leadership.
— Communicate effectively with team members while working remotely.
Requirements:
— Bachelor’s degree (BA/BS) in a related field.
— Minimum 15 years of relevant experience in Medicaid investigative roles focused on fraud, waste, and abuse.
— Familiarity with investigative tools, data sources, and methodologies used in FWA detection and analysis.
— Knowledge of healthcare FWA concepts, schemes, trends, and investigative approaches.
— Ability to clearly communicate complex fraud-related findings to enable quick action.
— Team-oriented mindset to collaborate across cross-functional teams including data scientists, clinicians, and other FWA SMEs.
— US work visa sponsorship will not be provided.
Benefits:
— AI-powered career tools for growth and learning opportunities.
— Internal mobility team support.
— Comprehensive benefits including medical, dental, vision, 401(k) with company match, paid time off, and wellness packages.
— Full-flex work week for work-life balance.
— Military-friendly and innovative workplace culture.
Additional Information:
— Scheduled weekly hours: 40.
— Travel required: Less than 10%.
— Work location: Remote, any location.
— Salary range: $153,000 - $207,000 annually, dependent on experience and location.
— Identity verification process involving biometrics and AI during hiring.
— No clearance required but NACI (T1) public trust is required.
— Citizenship not required.
— No work visa sponsorship provided.
Контакты работодателя доступны по кнопке «Откликнуться» после входа.