Certified Program Integrity Analyst

A company is looking for a Program Integrity Controls Analyst III (Certification Required). Key Responsibilities Lead implementation of Program Integrity requirements for Medicaid/Medicare Monitor and audit Grievance and Appeals for fraud trends and compliance Draft and submit responses to state and federal audits and inquiries Required Qualifications, Training, and Education Bachelor's Degree in Compliance, Healthcare, or a Legal field or equivalent experience Minimum of four (4) years of experience in a compliance or legal field Experience in internal and external auditing, risk management, and performance improvement Previous experience in financial calculations Experience with Marketplace, Medicaid, and/or Medicare products is preferred

Jun 11, 2025 - 15:40

A company is looking for a Program Integrity Controls Analyst III (Certification Required). Key Responsibilities Lead implementation of Program Integrity requirements for Medicaid/Medicare Monitor and audit Grievance and Appeals for fraud trends and compliance Draft and submit responses to state and federal audits and inquiries Required Qualifications, Training, and Education Bachelor's Degree in Compliance, Healthcare, or a Legal field or equivalent experience Minimum of four (4) years of experience in a compliance or legal field Experience in internal and external auditing, risk management, and performance improvement Previous experience in financial calculations Experience with Marketplace, Medicaid, and/or Medicare products is preferred