Remote Medicare/Medicaid Program Integrity Expert

Remote Jobs; United States; Remote; USD 90,000 - 130,000; Full time

Job summary

USmax Corporation is a remote, mission-driven provider of professional IT services specializing in federal healthcare program integrity. The role focuses on reviewing CMS guidance, developing educational materials, and advising CPI stakeholders on program integrity initiatives.

The ideal candidate brings deep CMS CPI knowledge, strong communication skills, and the ability to work independently in a fast-paced environment with tight deadlines.

Qualifications

• Proficient in Microsoft Office applications (Outlook, Word, Excel, PowerPoint, SharePoint).
• Excellent verbal and written communication and presentation skills.
• Ability to anticipate project needs and support strategy/implementation.

Responsibilities

• Review peer submissions for quality and CMS compliance.
• Serve as the Program Integrity subject matter expert for CMS PI questions.
• Translate CMS PI guidance into educational materials for CPI stakeholders.
• Research CMS regulations and policy updates.
• Provide expert consultation on Program Integrity initiatives.
• Review educational content for technical accuracy.
• Identify emerging fraud schemes and vulnerabilities.
• Support development of fact sheets, toolkits, webinars, and training products.
• Participate in stakeholder meetings and workgroups.

Skills

MS Office

Excel formulas

Communication skills

Independent worker

Project coordination

Education

Bachelor's degree

Tools

SharePoint

Job description

USmax Corporation is a remote, mission-driven provider of professional IT services specializing in federal healthcare program integrity. The role focuses on reviewing CMS guidance, developing educational materials, and advising CPI stakeholders on program integrity initiatives.

The ideal candidate brings deep CMS CPI knowledge, strong communication skills, and the ability to work independently in a fast-paced environment with tight deadlines.