Investigative Analyst (CMS Healthcare Claims)

General Dynamics
United States
Workplace: RemoteFull timeUSD 83,927 - 113,549 annuallyFunction: Healthcare (Clinical, Medical, Wellness)Experience: 8+ yearsEducation: bachelorsSkills: ["Communication","Leadership","Confidentiality","Organization","Decision-making"]

Analyze healthcare claims data to identify fraud, waste, and abuse in support of the CMS program. Mine partnership data using internal tools, collaborate on HFPP analytics reports, and generate referrals and leads for Partners while tracking outcome metrics. Work with a 50-person team remotely, using tools like Tableau and Office, and apply HIPAA privacy knowledge to ensure compliant handling of sensitive data.

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FursaFursa
General Dynamics
General Dynamics
2 days ago

Investigative Analyst (CMS Healthcare Claims)

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Source: Company careers pageValidated by: Fursa AI
Last checked: 2 hours agoStatus: Live

Job Summary

Analyze healthcare claims data to identify fraud, waste, and abuse in support of the CMS program. Mine partnership data using internal tools, collaborate on HFPP analytics reports, and generate referrals and leads for Partners while tracking outcome metrics. Work with a 50-person team remotely, using tools like Tableau and Office, and apply HIPAA privacy knowledge to ensure compliant handling of sensitive data.
Location: United States
Workplace: Remote
Employment Type: Full time
Job Function: Healthcare (Clinical, Medical, Wellness)
Seniority: Mid level

Key Responsibilities

  • •Perform analytical tasks for the HFPP program, identifying fraud, waste, and abuse referrals and leads from HFPP analytics.
  • •Conduct data mining across the partnership using internal tools.
  • •Collaborate on HFPP analytic reports and drive outcome metrics for referrals and leads shared with Partners.
  • •Interact with Partners regularly regarding referrals and leads identified.
  • •Support business development activities such as analyzing health claims data and developing provider background profiles.
Travel: Low travel

Pay and Benefits

Salary: USD 83,927 - 113,549 annually
Perks:Health InsuranceDentalVision401kPaid Leave

Key Requirements

  • •BA/BS or equivalent experience.
  • •8+ years of experience in health care claims analysis.
  • •Strong oral and written communication skills to present to management-level staff.
  • •Expert knowledge of Microsoft Office suite.
  • •Experience with Tableau, Amazon WorkSpaces, Jira, and Confluence; working knowledge of HIPAA privacy and security rules.
Experience:8+ yearsHealthcareHealth insuranceClaims
Education:Bachelor's
Skills:CommunicationLeadershipConfidentialityOrganizationDecision-making
Tech Stack:Microsoft OfficeTableauAmazon WorkSpacesJiraConfluenceHIPAA

Eligibility

Work Authorization:Authorization required. Sponsorship not provided.

Company Brief

General Dynamics
Provides IT, systems engineering, cybersecurity, cloud, and mission support services to U.S. federal civilian and defense agencies, delivering large-scale technology solutions and managed services for national security and government operations.
Industry: Defense Technology
Company Size: Enterprise (1,001+ employees)
Growth: Established Company
Headquarters: Tysons / Fairfax, United States
WebsiteLinkedIn