Investigative Analyst – CMS Healthcare Claims

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $77.8k - $105.2k / year

⏰ Full Time

🟠 Senior

🔴 Lead

🧐 Analyst

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

General Dynamics Information Technology

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1954

💼 Consulting

🏥 Healthcare

📦 Logistics

Consulting • Healthcare • Logistics

General Dynamics Information Technology is a company at the forefront of technological innovation, offering a wide range of services including consulting, digital modernization, and application services. The company is heavily involved in implementing solutions related to artificial intelligence, cloud computing, cybersecurity, high-performance computing, and quantum technologies. GDIT is committed to supporting government and defense sectors, providing mission-critical services such as logistics and supply chain management, intelligence, and homeland security. The company also focuses on diverse and inclusive hiring practices and actively promotes employee well-being. Through its digital accelerator solutions and pioneering use of emerging technologies, GDIT aims to propel agencies' missions forward and address complex technological challenges.

📋 Description

• Perform analytical tasks supporting the HFPP program • Identify fraud, waste, and abuse referrals and leads from HFPP Analytics • Conduct data mining across the partnership using internal tools • Collaborate on HFPP analytic reports • Develop fraud, waste, and abuse referrals and leads for Partners based on analytic reports • Drive outcome metrics related to referrals and leads shared with Partners • Interact regularly with Partners regarding identified referrals and leads • Support business development activities, including analyzing health claims data, generating study referrals and leads, developing provider background profiles, and identifying opportunities for Partner collaboration meetings • Support CMS and the Trusted Third Party in reducing healthcare fraud, waste, and abuse

🎯 Requirements

• BA/BS or equivalent experience • 8+ years of experience in health care claims analysis • 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 • Strong decision-making, organizational, prioritization, and interpersonal skills • Ability to independently follow through on problems • Ability to work on complex projects with general direction and minimal guidance • Ability to work effectively both independently and in a team environment • Work visa sponsorship will not be provided • Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud Investigator (AHFI) designation strongly desired • Certified clinical coding preferred

🏖️ Benefits

• Comprehensive medical plan options, including plans with Health Savings Accounts • Dental plan options • Vision plan • 401(k) plan with company match • Full-flex work weeks • Paid time off, including vacation, sick, personal, holiday, parental, military, bereavement, and jury duty leave • Typically 15 days of paid leave per calendar year • 10 paid holidays per year • Up to 160 hours of paid family leave in a rolling 12-month period for eligible employees • Short- and long-term disability benefits • Life insurance • Accidental death and dismemberment insurance • Personal accident insurance • Critical illness insurance • Business travel and accident insurance • Growth tool identifying career steps and learning opportunities • Internal mobility support • Wellness packages • Award-winning culture of innovation • Military-friendly workplace