Medicaid Audit Project Coordinator (Remote)

Peraton; Reston (VA); Remote; USD 66,000 - 106,000; Full time

Job summary

Peraton seeks a Project Coordinator to support SafeGuard Services (SGS) in Medicaid audit initiatives. You will bridge business needs and technical solutions, coordinating with internal teams to develop projects and validating data for reliability and actionability.

The role requires strong project management, data strategy, and technical knowledge to drive accurate audit findings. Telework is available nationwide in the US, with a focus on governance across CMS and State Agencies.

Qualifications

• 5 years with BS/BA; or 9 years with a HS Diploma/equivalent.
• Healthcare policy and regulation experience (Medicaid preferred).
• Strong research skills.
• Strong communication and organization skills.
• Strong writing skills.
• Strong computer skills including Microsoft Access, relational data base design, extract, and reporting, Excel, and the Internet.
• Strong analytical ability and knowledge of statistics & sampling techniques.
• Proven ability to work with a variety of systems, data sources, and analytic tools.
• Excellent organizational and communication skills.
• US citizenship required.

Responsibilities

• Lead projects arising from discoveries of potential fraud, waste or abuse in Medicaid.
• Develop project methodologies and coordinate with internal teams.
• Apply data analysis to detect aberrancies in Medicaid claims data and pursue leads from CMS, OIG, State programs, and other authorities.
• Review claims history/provider files to identify fraudulent or abusive patterns and vulnerabilities.
• Make potential fraud determinations using guidelines, Medicaid manuals, regulations, and the Social Security Act.
• Identify fraud alerts and vulnerabilities for CMS submission; share findings with Medicaid contractors and law enforcement.
• Track and report Medicaid project progress to CMS and States.
• Coordinate workflow from project to lead stage and across teams.
• Engage with UPICs for potential project development and respond to information requests.

Skills

Research skills

Communication

Organization

Microsoft Access

Relational database design

Excel

Statistics

Data analysis

US citizenship

Education

BS/BA in relevant field

HS Diploma/equivalent

Tools

Microsoft Access

Relational databases

Data extraction & reporting

Excel

Internet

Job description

Peraton seeks a Project Coordinator to support SafeGuard Services (SGS) in Medicaid audit initiatives. You will bridge business needs and technical solutions, coordinating with internal teams to develop projects and validating data for reliability and actionability.

The role requires strong project management, data strategy, and technical knowledge to drive accurate audit findings. Telework is available nationwide in the US, with a focus on governance across CMS and State Agencies.