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**Req ID:** RQ208782

**Type of Requisition:** Regular

**Clearance Level Must Be Able to Obtain:** None

**Public Trust/Other Required:** None

**Job Family:** Ancillary Health

Skills:

Claims Data,Data Analysis,Microsoft Excel,Policy Analysis,Strategic Objectives

Certifications:

Certified Fraud Examiner (CFE) | Association of Certified Fraud Examiners (ACFE) - Association of Certified Fraud Examiners (ACFE)

Experience:

5 + years of related experience

Job Description:

At GDIT, people are our differentiator. As an Investigative Analyst supporting 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.

We are GDIT. The people supporting and securing some of the most complex government, defense, and intelligence projects across the country. We ensure today is safe and tomorrow is smarter. Our work has meaning and impact on the world around us, but also on us, and that’s important.

GDIT is your place. You make it your own by embracing autonomy, seizing opportunity, and being trusted to deliver your best every day.

We think. We act. We deliver. There is no challenge we can’t turn into opportunity. Our work depends on a Partner Liaison joining our team to support CMS Trusted Third Party activities.

HOW AN INVESTIGATIVE ANALYST WILL MAKE AN IMPACT:

+ 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

WHAT YOU'LL NEED TO SUCCEED:

+ BA/BS or equivalent experience

+ 5+ years’ 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.

SECURITY CLEARANCE LEVEL:

+ Must be able to obtain a public trust clearance

DESIRED QUALIFICATIONS AND EXPERIENCE:

+ Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud Investigator (AHFI) designation strongly desired.

+ Certified clinical coding

SOFT SKILLS QUALIFICATIONS:

+ Strong decision-making skills and a demonstrated history of established leadership qualities as well as proven organizational skills.

+ Commitment to confidentiality, privacy, and professionalism.

+ Ability to independently follow through on problems.

+ Detail oriented and ability to prioritize multiple tasks and work under pressure.

+ Ability to work on complex projects with general direction and minimal guidance

+ Ability to build effective relationships, demonstrating strong interpersonal skills.

+ Exhibit high initiative to get things accomplished; high organizational ability to juggle multiple priorities.

+ Ability to perform well and achieve goals both in a team environment, with staff at all levels, and independently.

The likely salary range for this position is $85,000 - $115,000. 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.

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 IRS annual limits and receive a company match. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. GDIT typically provides new employees with 15 days of paid leave per calendar year to be used for vacations, personal business, and illness and an additional 10 paid holidays per year. Paid leave and paid holidays are prorated based on the employee’s date of hire. The GDIT Paid Family Leave program provides a total of up to 160 hours of paid leave in a rolling 12 month period for eligible employees. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most.

We are GDIT. A global technology and professional services company that delivers consulting, technology and mission services to every major agency across the U.S. government, defense and intelligence community. Our 30,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50 countries worldwide, offering leading capabilities in digital modernization, AI/ML, Cloud, Cyber and application development. Together with our clients, we strive to create a safer, smarter world by harnessing the power of deep expertise and advanced technology.

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Equal Opportunity Employer / Individuals with Disabilities / Protected Veterans