Healthcare Fraud SME

Headquarters: Maryland, United States URL: https://www.gdit.com Type of Requisition: Regular Clearance Level Must Currently Possess: None Clearance Level Must Be Able to Obtain: None Public Trust/Other Required: NACI (T1) Job Family: Functional Experts Job Qualifications: Skills: Fraud Analytics, Leadership, Medicaid, Medicare, Work Collaboratively Certifications: None Experience: 15 + years of related experience US Citizenship Required: No Job Description: Make meaningful contributions that fuel critical outcomes for some of the most complex government, defense, and intelligence projects. Join GDIT as a Healthcare Fraud, Waste and Abuse (FWA) Subject Matter Expert (SME) for a career where your growth is just as important as the mission you support. As a Healthcare FWA SME, the work you’ll do at GDIT will be impactful to the mission of the Centers for Medicare & Medicaid Services (CMS). * **Work visa sponsorship will not be provided for this role. HOW A HEALTHCARE FRAUD SME WILL MAKE AN IMPACT: • Leading efforts of technical tasks to completion independently and as part of a team. • Leading efforts to analyze claims data and reviews Federal and State Medicaid law, regulation, and policy. • Developing data-driven solutions to business challenges of advanced scope/complexity. • Collaborating with predictive modeling teams to increase and optimize customer experiences, efficiencies, process improvements, and other business outcomes. • Identifying opportunities for leveraging Medicare and Medicaid data to drive insightful business solutions. • Presenting findings to a range of audiences (technical/non-technical) and to various levels of leadership. • Effectively communicating with team members while working remotely WHAT YOU 'LL NEED TO SUCCEED: • Bachelor’s degree (BA/BS) in a related field. • Minimum of 15 years of relevant experience in Medicaid investigative roles focused on fraud, waste, and abuse. • Familiarity with investigative tools, data sources, and methodologies commonly used in FWA detection and analysis. • Knowledge of healthcare FWA concepts, schemes, trends, and investigative approaches. • Ability to communicate complex fraud-related findings in a clear, concise way that enables quick action. • Team-oriented outlook to facilitate collaboration across a cross-functional team of data scientists, clinicians, and other FWA SMEs. GDIT IS YOUR PLACE: • At GDIT, the mission is our purpose, and our people are at the center of everything we do. • Growth: AI-powered career tool that identifies career steps and learning opportunities. • Support: An internal mobility team focused on helping you achieve your career goals. • Rewards: Comprehensive benefits and wellness packages, 401K with company match, and competitive pay and paid time off. • Flexibility: Full-flex work week to own your priorities at work and at home. • Community: Award-winning culture of innovation and a military-friendly workplace. OWN YOUR OPPORTUNITY: Explore a career at GDIT and you’ll find endless opportunities to grow alongside colleagues who share your ambition to deliver your best work. The likely salary range for this position is $153,000 - $207,000. 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. Scheduled Weekly Hours: 40 Travel Required: Less than 10% T elecommuting Options: Remote Work Location: Any Location / Remote Additional Work Locations: Total Rewards at GDIT: Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 401(k) plan offering the