Sr. Research Analyst / Medicare SME

General Dynamics Information Technology is a premier provider of high-tech IT solutions to the government IT market. We deliver cost-effective, next-generation IT solutions and services to the Department of Defense, the intelligence community and federal civilian agencies as they modernize their information systems.

GDIT is currently seeking a Medicare Subject Matter Consultant to join our team. In this role you will be a change agent by supporting the Center for Medicare & Medicaid Services in the mission to detect and prevent fraud, waste and abuse.

RESPONSIBILITIES:

• Provides subject matter expertise related to healthcare policy, guidelines, payment regulations and Medicare and Medicaid claims data.

• Independently conduct research and support team of programmers and statisticians on the development of statistical models and algorithms to detect and prevent potential fraud, waste or abuse in Medicare and Medicaid programs.

• Conduct analysis of data, trends, anomalies and patterns to identify potential vulnerabilities or abuse for further investigation.

• Conducts detailed policy research to understand Medicare, Medicaid and Managed Care payment guidelines, regulations, clinical indications and limitations to support analytics and research studies.

• Work independently and as a part of a team, document analysis and findings and present research and findings to internal and external teams and leadership.

QUALIFICATIONS:

Required Skills and Experience - 

• Bachelors Degree required, Masters Degree preferred

• Must have at least 10 years of experience in healthcare, policy, research or analytics

• Must be familiar with Medicare and Medicaid policies and programs

Desired Skills and Experience:

• Experience in Medicare and Medicaid managed care programs, reimbursement and audits

• Experience using data mining or business intelligence tools such as Business Objects, SQL, SAS, SPSS

• Experience supporting program integrity functions for CMS in the detection of vulnerabilities and solutions to prevent waste and abuse

ATTRIBUTES FOR SUCCESS:

• Strong verbal and written communication

• Self motivated and able to balance multiple priorities

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The likely salary range for this position is $108,000 - $162,000, this is not, however, a guarantee of compensation or salary; rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.

View information about benefits and our total rewards program.