Program Integrity Lead

Type of Requisition:

Clearance Level Must Currently Possess:

Clearance Level Must Be Able to Obtain:

Public Trust/Other Required:

Job Family:

Job Qualifications:

Skills:

Certifications:

Experience:

US Citizenship Required:

Job Description:

Program Integrity Lead

Make meaningful contributions that fuel critical outcomes for some of the most complex government, health, and program integrity projects. Join GDIT as a Program Integrity Lead for a career where your growth is just as important as the mission you support.

MEANINGFUL WORK AND PERSONAL IMPACT

As a Program Integrity Lead, the work you’ll do at GDIT will be impactful to the mission of Medicare and Medicaid Program Integrity Programs. You will play a crucial role in overseeing pro.gram integrity tasks, researching Medicare and Medicaid policy, conducting data linkage and program integrity analyses, analyzing trends in Medicare payment systems, and documenting research findings. You will assist with utilizing new Medicare and Medicaid data for program integrity evaluation and exploring data for research and evaluation.

● Lead all program integrity tasks and manage a team of research managers and data scientists to analyze, summarize, validate, and report findings.
● Collaborate with multidisciplinary teams supporting CMS’s evaluation of program integrity activities and targeted analyses.

● Develop written materials and reports regarding program integrity findings, cost savings, and methodologies used with research and analysis.

● Document and report on monitoring methods, policy impacts, pricing replication algorithms, and advanced claims analyses.

● Document and report on data integrity and/or reliability issues for utilization of multiple CMS data sources.

● Drive program integrity analysis and evaluation projects to identify new savings methodologies, research Medicare and Medicaid policy impacts, and provide detailed reports and visualizations of research findings, data decisions, and methodologies.

WHAT YOU’LL NEED TO SUCCEED
Bring your Medicare/Medicaid Program Integrity expertise along with a drive for innovation to GDIT.

Education: Master of Arts/Science; PhD preferred

Required Experience​​:

• 15+ years of related experience (Medicare/Medicaid program integrity, research and statistical analysis); understanding of Medicare payment policy, Medicare provider enrollment policy, and CMS’s program integrity initiatives; experience with CMS Medicare data (e.g., Medicare fee-for-service claims data, Part D data, provider enrollment data, case management data) and Medicaid data (e.g., T-MSIS)
• Technical skills: Research and analytics using R or Python, understanding of machine learning and artificial intelligence, Tableau or related data visualization tools.
• Security clearance level: Public trust

Location: Remote

GDIT IS YOUR PLACE

• At GDIT, the mission is our purpose, and our people are at the center of everything we do
• Growth: AI-powered career tool that identifies career steps and learning opportunities
• Support: An internal mobility team focused on helping you achieve your career goals
• Rewards: Comprehensive benefits and wellness packages, 401K with company match, and competitive pay and paid time off
• Flexibility: Full-flex work week
• Community: Award-winning culture of innovation and a military-friendly workplace

OWN YOUR OPPORTUNITY

Explore a career at GDIT and you’ll find endless opportunities to grow alongside colleagues who share your ambition to deliver your best work.