[Hiring] Investigative Analyst @General Dynamics Information Technology

Role Description

GDIT is hiring a healthcare claims Investigative Analyst to support the Centers for Medicare and Medicaid (CMS). You will be trusted to identify trends in the data and create leads and referrals for the Healthcare Fraud Prevention Partnership (HFPP) members (Partner) and the Trusted Third Party (TTP). You will be part of a 50-person team supporting the TTP which was established in 2012 to reduce fraud, waste, and abuse in healthcare data. This position is remote. Work visa sponsorship will not be provided.

• Performs analytical tasks in support of HFPP program, including identifying fraud, waste, and abuse referrals and leads from HFPP Analytics.
• Conduct data mining across the partnership utilizing internal tools.
• Collaborate on the development of HFPP analytic reports.
• Develops fraud, waste, and abuse referrals and leads for Partners based on HFPP analytic reports.
• Drive outcome metrics related to fraud, waste, and abuse referrals and leads shared with Partners.
• Interacts regularly with Partners regarding referrals and leads identified.
• May perform business development activities including analyzing health claims data, generating study referrals and leads, developing provider background profiles, and identifying opportunities for Partner collaboration meetings.

Qualifications

• BA/BS or equivalent experience.
• 8+ years’ experience in health care claims analysis (equivalent work experience will be considered in lieu of degree).
• Strong oral and written communication skills with the ability to present to management level staff.
• Expert level knowledge of Microsoft Office suite.
• Experience with Tableau, Amazon WorkSpaces, Jira, and Confluence.
• Working knowledge of HIPAA privacy and security rules.

Requirements

• Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud Investigator (AHFI) designation strongly desired.
• Certified clinical coding.

Benefits

• Comprehensive benefits and wellness packages.
• 401K with company match.
• Competitive pay and paid time off.
• Full-flex work week to own your priorities at work and at home.
• Award-winning culture of innovation and a military-friendly workplace.