Remote Medicaid FWA Analytics Lead

Gainwell Technologies LLC; Oregon; Hybrid; USD 69.000 - 99.000; Vollzeit

Benefits dieser Stelle

Flexible vacation policy

Educational assistance

Leadership academies

Technical development academies

401(k) employer match

Comprehensive health benefits

Zusammenfassung

Gainwell Technologies is seeking a Senior Analyst for Medicaid Fraud, Waste & Abuse to support state Medicaid agencies by applying analytic models to claims data and delivering monthly lead referrals. This role emphasizes producing clear, defensible intelligence for OIG and program integrity stakeholders.

The analyst will present findings, respond to questions, and support investigations through data interpretation and documentation, with travel as needed. Fully remote within the United States.

Qualifikationen

• 5+ years analyzing Medicaid claims and encounter data for fraud, waste and abuse.
• Deep knowledge of Medicaid program integrity, FWA schemes, audit methodologies, and investigations.
• 4+ years preparing reports and presentations documenting analytic methods and results.
• Experience reading and applying Medicaid policy, regulations, and related guidance.
• Strong written and verbal communication, with experience presenting findings to state agencies.

Aufgaben

• Apply established FWA analytic models to Medicaid claims data to identify potential fraud, waste and abuse.
• Deliver monthly, prequalified FWA lead referral reports.
• Produce clear, defensible analytic reports for non-technical audiences.
• Present FWA leads to state Medicaid program integrity and OIG staff.
• Provide testimony or investigative support as needed and respond to follow-up questions.

Kenntnisse

Medicaid claims analysis

Medicaid program integrity

Analytic reporting

Policy interpretation

Stakeholder communication

Jobbeschreibung

Gainwell Technologies is seeking a Senior Analyst for Medicaid Fraud, Waste & Abuse to support state Medicaid agencies by applying analytic models to claims data and delivering monthly lead referrals. This role emphasizes producing clear, defensible intelligence for OIG and program integrity stakeholders.

The analyst will present findings, respond to questions, and support investigations through data interpretation and documentation, with travel as needed. Fully remote within the United States.