Healthcare Fraud SME

Headquarters: Maryland, United States

URL: https://www.gdit.com

Type of Requisition:

Regular

Clearance Level Must Currently Possess:

None

Clearance Level Must Be Able to Obtain:

None

Public Trust/Other Required:

NACI (T1)

Job Family:

Functional Experts

Job Qualifications:

Skills:

Fraud Analytics, Leadership, Medicaid, Medicare, Work CollaborativelyCertifications:

NoneExperience:

15 + years of related experienceUS Citizenship Required:

No

Job Description:

Make meaningful contributions that fuel critical outcomes for some of the most complex government, defense, and intelligence projects. Join GDIT as a Healthcare Fraud, Waste and Abuse (FWA) Subject Matter Expert (SME) for a career where your growth is just as important as the mission you support.

As a Healthcare FWA SME, the work you’ll do at GDIT will be impactful to the mission of the Centers for Medicare & Medicaid Services (CMS).

***Work visa sponsorship will not be provided for this role.

HOW A HEALTHCARE FRAUD SME WILL MAKE AN IMPACT:

• 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.
• Developing data-driven solutions to business challenges of advanced scope/complexity.
• Collaborating with predictive modeling teams to increase and optimize customer experiences, efficiencies, process improvements, and other business outcomes.
• Identifying opportunities for leveraging Medicare and Medicaid data to drive insightful business solutions.
• Presenting findings to a range of audiences (technical/non-technical) and to various levels of leadership.
• Effectively communicating with team members while working remotely

WHAT YOU'LL NEED TO SUCCEED:

**

**

• Bachelor’s degree (BA/BS) in a related field.
• Minimum of 15 years of relevant experience in Medicaid investigative roles focused on fraud, waste, and abuse.
• Familiarity with investigative tools, data sources, and methodologies commonly used in FWA detection and analysis.
• Knowledge of healthcare FWA concepts, schemes, trends, and investigative approaches.
• Ability to communicate complex fraud-related findings in a clear, concise way that enables quick action.
• Team-oriented outlook to facilitate collaboration across a cross-functional team of data scientists, clinicians, and other FWA SMEs.

GDIT IS YOUR PLACE:

• At GDIT, the mission is our purpose, and our people are at the center of everything we do.
• Growth: AI-powered career tool that identifies career steps and learning opportunities.
• Support: An internal mobility team focused on helping you achieve your career goals.
• Rewards: Comprehensive benefits and wellness packages, 401K with company match, and competitive pay and paid time off.
• Flexibility: Full-flex work week to own your priorities at work and at home.
• Community: Award-winning culture of innovation and a military-friendly workplace.

OWN YOUR OPPORTUNITY:

Explore a career at GDIT and you’ll find endless opportunities to grow alongside colleagues who share your ambition to deliver your best work.

The likely salary range for this position is $153,000 - $207,000. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.

Scheduled Weekly Hours:

40

Travel Required:

Less than 10%

Telecommuting Options:

Remote

Work Location:

Any Location / Remote

Additional Work Locations:

Total Rewards at GDIT:

Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the...