Quality Analyst for Improper Health Care Benefits Payment Measurement Program

Clearance Level
Quality Assurance
Rockville, Maryland

REQ#: RQ48059

Travel Required: 10-25%
Public Trust: None
Requisition Type: Pipeline

GDIT is preparing for a hiring surge in 2020 to support the Centers for Medicare and Medicaid (CMS) Office of Financial Management (OFM). The CMS OFM is responsible for reducing healthcare exchange errors by establishing a measurement for the improper payment of Advanced Payments of the Premium Tax Credit (APTC) in a given benefit year while accounting for changes in the Patient Protection and Affordable Care Act (PPACA or ACA) policy and regulations.

The ACA is a comprehensive health care reform law enacted in March 2010. The law makes affordable health insurance available to more people, provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level, and supports the expansion of the Medicaid program to cover all adults with income below 138% of the federal poverty level.

Job Overview

Job opportunities are expected for ACA improper payment Quality Analyst to support the planning, design and execution of system testing on simple to complex implementations. In this role you will:

  • Develop test plans, test cases and test scripts for improper payment eligibility analyzation
  • Validate that user expectations are achieved during the testing process
  • Create, maintain, and improve data processing and storage systems in a continuous effort to reduce costs to the federal government
  • Contribute to data evaluations aimed at identifying and reducing the proportion of improper payments
  • Maintain standard payment measurement procedures and adapting them to regulatory or programmatic changes
  • Support the Difference Resolution and Appeals process, corrective action plans, and other related progressions
Responsibilities and Duties
  • Develop and execute test plans to ensure that all objectives are met
  • Implement and monitor test scripts to assess functionality, reliability, performance, and quality
  • Identify and remedy defects within the production process
  • Provide hands-on experience and interpret automated test script preparation and execution
  • Suggest creative and active solutions for problem
  • Resolve issues and express ingenuity as required
  • Assist in test defect management process, monitor and report on defect resolution to management
  • Evaluate large data amounts from different sources and develop useful summary reports
  • Develop and maintain quality assurance procedure documentation
  • Evaluate new technologies and methods to make recommendations regarding their use
  • Work collaboratively with internal and external organizations to report improper payment rates
  • Stay abreast of national healthcare policy changes
  • Skill in operating a personal computer, including Microsoft Word, Excel, and Skype
  • Work with a diverse range of people
  • Adapt to change
  • Deal calmly and effectively in high stress situations
  • Compose documents or correspondence involving technical information
  • Strong analytic skills

At minimum, Bachelor’s Degree and at least three (3) years of experience related to healthcare exchange enrollments or five (5) years of experience related to healthcare exchange enrollments in lieu of a Bachelor’s Degree

We are GDIT. The people supporting some of the most complex government, defense, and intelligence projects across the country. We deliver. Bringing the expertise needed to understand and advance critical missions. We transform. Shifting the ways clients invest in, integrate, and innovate technology solutions. We ensure today is safe and tomorrow is smarter. We are there. On the ground, beside our clients, in the lab, and everywhere in between. Offering the technology transformations, strategy, and mission services needed to get the job done.

GDIT is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status, or any other protected class.