General Dynamics

1 week ago

Nurse Analyst/Investigator

✓ Verified Job

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

Source: Company careers pageValidated by: Fursa AI

Last checked: 2 hours agoStatus: Live

Job Summary

Join the Fraud Prevention System (FPS) Modeling and Analytics team supporting CMS by using clinical expertise and analytical review to help detect and prevent fraud, waste, and abuse across Medicare and Medicaid. You’ll write and review FPS edit proposals, respond to urgent CMS requests, evaluate new edit topics using data and CMS policy (e.g., LCD/NCD), and consult on clinical and medical coding questions while working on technology and data science tools.

Location: Baltimore

Workplace: Remote

Employment Type: Full time

Job Function: Healthcare (Clinical, Medical, Wellness)

Seniority: Mid level

Key Responsibilities

•Interact with FPS program staff and leaders within GDIT and with other FPS entities and CMS.
•Write and review edit proposals and consult on policy, medical coding, and clinical questions.
•Respond to CMS urgent requests for information related to edits and other ad hoc program integrity requests.
•Review CMS policy and regulations to support new FPS edits and models.
•Identify and evaluate candidate topics for FPS edits using data and document CMS policy supporting the edit (e.g., LCD, NCD).

Travel: Low travel

Pay and Benefits

Salary: USD 93,500 - 126,500 annually

Perks:Health InsuranceDentalVision401kPaid LeavePaid Parental

Key Requirements

•RN or LPN with 5+ years of clinical experience.
•2+ years of experience in Medicare Program Integrity work at a MAC, UPIC or other program integrity contractor.
•2+ years of medical coding experience with appropriate professional certification(s) (e.g., CPC) or ability to attain certification within 12 months.
•Working knowledge of Medicare policy, processes, and claims payment systems.
•Ability to pass CMS security clearance and background check.

Experience:10+ years

Education:Bachelor's

Skills:Analytical thinkingClinical reviewFraud prevention

Certifications:CPC

Tech Stack:Microsoft Excel

Eligibility

Security Clearance:CMS security clearance

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

1 week ago

Nurse Analyst/Investigator

✓ Verified Job

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

Source: Company careers pageValidated by: Fursa AI

Last checked: 2 hours agoStatus: Live

Job Summary

Location: Baltimore

Workplace: Remote

Employment Type: Full time

Job Function: Healthcare (Clinical, Medical, Wellness)

Seniority: Mid level

Key Responsibilities

•Interact with FPS program staff and leaders within GDIT and with other FPS entities and CMS.
•Write and review edit proposals and consult on policy, medical coding, and clinical questions.
•Respond to CMS urgent requests for information related to edits and other ad hoc program integrity requests.
•Review CMS policy and regulations to support new FPS edits and models.
•Identify and evaluate candidate topics for FPS edits using data and document CMS policy supporting the edit (e.g., LCD, NCD).

Travel: Low travel

Pay and Benefits

Salary: USD 93,500 - 126,500 annually

Perks:Health InsuranceDentalVision401kPaid LeavePaid Parental

Key Requirements

•RN or LPN with 5+ years of clinical experience.
•2+ years of experience in Medicare Program Integrity work at a MAC, UPIC or other program integrity contractor.
•2+ years of medical coding experience with appropriate professional certification(s) (e.g., CPC) or ability to attain certification within 12 months.
•Working knowledge of Medicare policy, processes, and claims payment systems.
•Ability to pass CMS security clearance and background check.

Experience:10+ years

Education:Bachelor's

Skills:Analytical thinkingClinical reviewFraud prevention

Certifications:CPC

Tech Stack:Microsoft Excel

Eligibility

Security Clearance:CMS security clearance

Company Brief

General Dynamics

Industry: Defense Technology

Company Size: Enterprise (1,001+ employees)

Growth: Established Company

Headquarters: Tysons / Fairfax, United States

Website LinkedIn