Healthcare FWA Consultant

Clearance Level
None
Category
Data Analysis
Location
Not Applicable, Florida

REQ#: RQ69274

Travel Required: Less than 10%
Public Trust: None
Requisition Type: Regular

General Dynamics Information Technology and CSRA have united to create the premier provider of high-tech IT solutions to the government IT market. Together as General Dynamics Information Technology, 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 FWA 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

    As a trusted systems integrator for more than 50 years, General Dynamics Information Technology provides information technology (IT), systems engineering, professional services and simulation and training to customers in the defense, federal civilian government, health, homeland security, intelligence, state and local government and commercial sectors. With approximately 32,000 professionals worldwide, the company delivers IT enterprise solutions, manages large-scale, mission-critical IT programs and provides mission support services. 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.

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.