A job opportunity is expected for a Senior Technical Editor for an Affordable Care Account Program Integrity contract. In this role you will prepare, review, revise, and maintain technical documents related to the program, as well as assist with project management requests. You will report to the Deputy Program Manager and support the Project Management Office in all project management needs. In this role you will:
Develop quality control plans for improper payment eligibility analyzation
Validate data and metrics during the reconciliation process
Create, maintain, and improve data processing 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 adapt them to regulatory or programmatic changes
Support the Difference Resolution and Appeals process, corrective action plans, and other related progressions
Responsibilities + Duties
Develop and execute quality plans to ensure that all objectives are met
Implement and monitor processes to assess functionality, reliability, performance, and quality of reporting
Identify and remedy defects within the production process
Oversees and may perform quality trainings. Oversees the documentation of the entire quality testing process
May provide guidance and work leadership to less-experienced analysts.
Provide hands-on experience and suggest creative and active solutions for problem
Resolve issues and express ingenuity as required
Assist in 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
Work collaboratively with internal and external organizations to report improper payment rates
Stay abreast of national healthcare policy changes, rules, regulations, guidelines, and mandates
Organize, prioritize, and track the completion of their workload using SharePoint
Maintain a high-level understanding of the ACA and stay abreast of policy changes at the national level, which may impact documentation.
Attend and participate in meetings, trainings, work groups and quality initiatives as assigned
Prioritize and meet deadlines
Establish and maintain effective working relationships
Apply ethical business practices
Experience working with health-related billing and reconciliation
Strong audit and/or investigative experience
Follows the Lean Six Sigma model
Excellent analytic and communication skills
Skill in Microsoft Word and Excel
Work with a diverse range of people
Adapt easily to change
Deal calmly and effectively in high stress situations
Compose documents or correspondence involving technical information
Master's Degree and at least ten (10) years of experience related to health insurance or Bachelor's Degree and fifteen (15) years of experience.
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.