Program Integrity Audit Analyst II

Remote Jobs; United States; Remote; USD 55,000 - 65,000; Full time

Job summary

A leading investigative services firm is seeking to hire an Audit Specialist to conduct performance audits of Medicaid Managed Care Plans, identify potential fraud, and improve contract compliance. The role offers a salary of up to $65,000 annually, remote work flexibility, and a comprehensive benefits package including 401(k) matching. Candidates should have at least one year of auditing experience and excellent communication skills.

Benefits

Comprehensive benefits package including medical, dental, and vision plans

401(k) with company match up to 4%

Paid Time Off and company-paid holidays

Opportunities for tuition assistance after one year of service

Qualifications

• Minimum of one year of experience conducting performance or compliance audits.
• Strong communication and organization skills.

Responsibilities

• Conduct performance audits to identify fraud, waste, and abuse.
• Design audit strategies for payment reviews.
• Document findings and recommendations for compliance.
• Prepare reports in accordance with professional standards.
• Mentor/trainer for new staff.

Skills

Proficiency with Microsoft Word

Proficiency with Excel

Excellent verbal and written communication skills

Strong research skills

Organization skills

Prioritization skills

Time management skills

Education

High School Diploma or G.E.D.

Relevant college or technical degrees

Job description

Employer Industry: Investigative Services

Why consider this job opportunity:

• Salary up to $65,000 annually
• Comprehensive benefits package including medical, dental, and vision plans
• 401(k) with company match up to 4%
• Paid Time Off and company-paid holidays
• Opportunities for tuition assistance after one year of service
• Remote work flexibility available

What to Expect (Job Responsibilities):

• Conduct performance audits of Medicaid Managed Care Plans to identify potential fraud, waste, and abuse
• Design and implement audit strategies for provider payment reviews and managed care plan performance audits
• Document findings and recommendations for improved contract compliance and process improvement
• Prepare factual and objective written reports in accordance with professional auditing standards
• Serve as a mentor/trainer to new Program Integrity staff

What is Required (Qualifications):

• High School Diploma or G.E.D. equivalent; preference for candidates with relevant college or technical degrees
• Minimum of one (1) year of experience conducting performance or compliance audits
• Proficiency with Microsoft Word and Excel
• Excellent verbal and written communication skills
• Strong research, organization, prioritization, and time management skills

How to Stand Out (Preferred Qualifications):

• Certified Fraud Examiner (CFE) Certification
• Experience with state Medicaid programs or advanced degrees in relevant fields
• Knowledge of statistics and data analysis techniques
• Experience with inventory management and reporting systems