Medicaid Healthcare Fraud Data Analytics Lead (Remote)

General Dynamics Information Technology, Inc.; Oregon; Hybrid; USD 153,000 - 207,000; Full time

Benefits offered by this job

401K with company match

Paid time off

Remote work flexibility

Job summary

General Dynamics Information Technology, Inc. is seeking a Healthcare Fraud SME to lead analysis of Medicaid data, review laws and policy, and develop data-driven solutions across a cross-functional team including data scientists and clinicians.

You will present findings to leadership, contribute to strategic solutions, and work remotely with flexible scheduling. The role offers a comprehensive benefits package and a competitive salary range.

Qualifications

• Bachelor's degree in a related field is required.
• 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 used in FWA detection and analysis.
• Knowledge of healthcare FWA concepts, schemes, trends, and investigative approaches.
• Ability to communicate complex fraud-related findings clearly for quick action.
• Team-oriented outlook to collaborate with data scientists, clinicians, and other FWA SMEs.

Responsibilities

• 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 improve customer experiences, efficiencies, and processes.
• Identifying opportunities for leveraging Medicare and Medicaid data for insights.
• Presenting findings to audiences from technical to leadership levels.
• Communicating effectively with team members while working remotely.

Skills

Medicaid fraud analysis

Data analytics collaboration

Communication of complex findings

Team collaboration across cross‑func

Education

Bachelor's degree in related field

Tools

Investigative tools

Medicaid data sources

Job description

General Dynamics Information Technology, Inc. is seeking a Healthcare Fraud SME to lead analysis of Medicaid data, review laws and policy, and develop data-driven solutions across a cross-functional team including data scientists and clinicians.

You will present findings to leadership, contribute to strategic solutions, and work remotely with flexible scheduling. The role offers a comprehensive benefits package and a competitive salary range.