Nurse Analyst/Investigator

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🔥 0 minutes ago

🦀 Maryland – Remote

🦀 Maryland – Remote

💵 $93.5k - $126.5k / year

⏰ Full Time

🟠 Senior

🔴 Lead

🧐 Analyst

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General Dynamics Information Technology

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1954

🔒 Cybersecurity

🤖 Artificial Intelligence

Defense • Cybersecurity • Artificial Intelligence

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

• Support Centers for Medicare & Medicaid Services (CMS) activities at Baltimore, Maryland • Interact with staff and leaders in the FPS program, both within GDIT and with other entities working on FPS • Write and review edit proposals and consult with others regarding policy, medical coding, and clinical questions • Receive and reply to CMS urgent requests for information related to edits and other ad hoc program integrity requests • Review CMS policy and regulations to anchor support for new FPS edits and models • Identify new candidate topics for possible FPS edits and evaluate them by using data to identify risk and document CMS policy (e.g., LCD, NCD) that supports the edit

🎯 Requirements

• RN or LPN with 5+ years clinical experience • 2+ years of experience in Medicare Program Integrity work at a MAC, UPIC or other program integrity contractor • 2+ years of experience in medical coding with the corresponding appropriate professional certification(s) (e.g., CPC) or ability to attain certification within 12 months • Working knowledge of Medicare policy, processes and claims payment systems • Ability to pass CMS security clearance & background check • 3 years of experience interacting with and consulting with others with a different background/expertise in a team environment • BA/BS/BSN • CPC certification • 2+ years of experience working with Medicare Fee-for-Service pre-payment edits either in FPS, FISS, MCS, and/or VMS • Experience with Medicaid, Medicare Part C/D

🏖️ Benefits

• Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts • Dental plan options • Vision plan • 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match • Full flex work weeks where possible • A variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave • 15 days of paid leave per calendar year • 10 paid holidays per year • Eligible employees can receive up to 160 hours of paid leave in a rolling 12 month period for family leave • Short and long-term disability benefits • Life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance