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Healthcare Fraud Research Analyst, Senior
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$75,600 - $172,000 a year
Full-time
- Assist with developing and implementing the program's integrity-focused e nga gement and growth strategy.
- Assist the client in efforts to identify and assess exposure or vulnerability to fraud, waste, and abuse in CMS programs and provide support and assistance to state program integrity functions.
- Assess and monitor the impact of policy and payment changes on access to care, benefi cia ry health outcomes, and CMS program payments, while applying healthcare payer expertise to address payer strategic and operational priorities.
- Knowledge of CMS claims data in the IDR or CCW environment with Fee-for-Service ( FFS ) , Medicare Advantage encounter data, Medicaid data in the Transformed Medicaid Statistical Information System ( T-MSIS ) , or Prescription Drug Event ( PDE ) data
- Knowledge of the federal procurement and proposal process, and contract management principles
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