Program Integrity Analyst II (Fraud & Verification)

State of California; Sacramento (CA); Hybrid; USD 72,000 - 91,000; Full time

Job summary

State of California's Employment Development Department (EDD) Disability Insurance Branch seeks a detail-oriented Analyst I/II to join the Fraud and Medical Verification Unit. The Program Integrity Analyst will review identity documentation and claims, identify discrepancies, and determine appropriate actions to protect program integrity while serving workers and families.

The role involves analyzing fraud indicators, handling redeterminations and appeals, and coordinating with program offices.

Qualifications

• Knowledge of State Disability Insurance programs, policies, procedures, and claim processes.
• Experience analyzing complex records, identifying discrepancies, and preparing findings or recommendations.
• Ability to interpret laws, regulations, policies, and procedures to individual cases.
• Experience reviewing identity documentation, potential fraud indicators, appeals, or redeterminations.
• Strong written communication, including case summaries, correspondence, or reports.
• Experience using data to identify trends and improve operations.
• Ability to manage competing assignments independently and meet deadlines.

Responsibilities

• Independently reviews identity documentation, claim records, and correspondence to identify discrepancies and determine next steps.
• Analyzes complex matters involving identity verification, fraud indicators, appeals, and redeterminations; prepares supported findings and recommendations.
• Coordinates with DIB offices and partners to support program integrity.
• Uses data and case findings to identify trends and test program integrity tools and processes.

Skills

Disability Insurance

Fraud indicators

Data analysis

Written communication

Stakeholder collaboration

Job description

State of California's Employment Development Department (EDD) Disability Insurance Branch seeks a detail-oriented Analyst I/II to join the Fraud and Medical Verification Unit. The Program Integrity Analyst will review identity documentation and claims, identify discrepancies, and determine appropriate actions to protect program integrity while serving workers and families.

The role involves analyzing fraud indicators, handling redeterminations and appeals, and coordinating with program offices.