General Dynamics

2 days ago

Marketplace Investigator

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 23 hours agoStatus: Live

Job Summary

Conduct research, document review, outreach, and data analysis to support Marketplace Program Integrity activities under CMS’s MPIC. Evaluate consumer enrollment and agent/broker activity to identify potential fraud, waste, and abuse, applying ACA policies and regulations. Prepare case summaries, investigative plans of action, and comprehensive reports, while documenting investigative activity in case management systems and safeguarding PII/PHI.

Location: United States

Workplace: Remote

Employment Type: Full time

Job Function: Data Analytics & Business Intelligence

Key Responsibilities

•Conduct analysis, research, outreach, and document/data review in support of an MPIC team.
•Apply ACA policies and regulations to identify potential fraud, waste, and abuse using consumer enrollment and agent/broker compliance data.
•Develop and implement investigative plans of action (IPOA) with CMS approval when needed, using investigative techniques.
•Prepare case summaries and comprehensive reports, and make administrative recommendations to CMS based on findings.
•Maintain detailed documentation of lead and investigative activity in case management and tracking systems, including conducting interviews as approved.

Travel: Low travel

Pay and Benefits

Salary: USD 69,700 - 94,300 annually

Perks:Health InsuranceDentalVision401kPaid LeaveParental LeaveLearning Budget

Key Requirements

•Bachelor’s degree (or equivalent experience) in a healthcare field, including 2–4 years of ACA and/or Medicaid-Medicare experience.
•2+ years of experience and/or understanding of ACA policies and regulations for consumer enrollment requirements and Agent/Broker/Navigator responsibilities.
•Experience reviewing complex data reports and applying regulations to findings and data.
•Highly organized with the ability to multi-task and meet deadlines with limited oversight.
•Proficient computer skills, for example Microsoft Office (Word, Excel).

Experience:3+ yearsHealthcareACAMedicaid-MedicareFraud investigationsHealth insurance marketplace

Education:Bachelor's in healthcare

Skills:DocumentationInformation evaluationProblem solvingOrganizedMultitaskingCommunicationInterviewing

Tech Stack:Microsoft OfficeWordExcel

Eligibility

Security Clearance:NACI (T1)

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

Website LinkedIn

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General Dynamics

2 days ago

Marketplace Investigator

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 23 hours agoStatus: Live

Job Summary

Location: United States

Workplace: Remote

Employment Type: Full time

Job Function: Data Analytics & Business Intelligence

Key Responsibilities

•Conduct analysis, research, outreach, and document/data review in support of an MPIC team.
•Apply ACA policies and regulations to identify potential fraud, waste, and abuse using consumer enrollment and agent/broker compliance data.
•Develop and implement investigative plans of action (IPOA) with CMS approval when needed, using investigative techniques.
•Prepare case summaries and comprehensive reports, and make administrative recommendations to CMS based on findings.
•Maintain detailed documentation of lead and investigative activity in case management and tracking systems, including conducting interviews as approved.

Travel: Low travel

Pay and Benefits

Salary: USD 69,700 - 94,300 annually

Perks:Health InsuranceDentalVision401kPaid LeaveParental LeaveLearning Budget

Key Requirements

•Bachelor’s degree (or equivalent experience) in a healthcare field, including 2–4 years of ACA and/or Medicaid-Medicare experience.
•2+ years of experience and/or understanding of ACA policies and regulations for consumer enrollment requirements and Agent/Broker/Navigator responsibilities.
•Experience reviewing complex data reports and applying regulations to findings and data.
•Highly organized with the ability to multi-task and meet deadlines with limited oversight.
•Proficient computer skills, for example Microsoft Office (Word, Excel).

Experience:3+ yearsHealthcareACAMedicaid-MedicareFraud investigationsHealth insurance marketplace

Education:Bachelor's in healthcare

Skills:DocumentationInformation evaluationProblem solvingOrganizedMultitaskingCommunicationInterviewing

Tech Stack:Microsoft OfficeWordExcel

Eligibility

Security Clearance:NACI (T1)

Company Brief

General Dynamics

Industry: Defense Technology

Company Size: Enterprise (1,001+ employees)

Growth: Established Company

Headquarters: Tysons / Fairfax, United States

Website LinkedIn