Program Integrity Auditor

Summary

Join Analytica as a Program Integrity Auditor and contribute to enhancing the integrity of Medicaid programs nationwide. You will conduct comprehensive audits, ensuring compliance with federal and state regulations and identifying vulnerabilities to prevent fraud. This critical role involves extensive client engagement with state agencies and CMS. You will analyze data, prepare detailed reports, and present findings and recommendations. Analytica offers competitive compensation, including bonuses, employer-paid healthcare, training funds, and a 401k match. The company is a fast-growing, award-winning firm committed to diversity and inclusion.

Requirements

• Possess a Bachelor’s degree or higher in business, healthcare administration, public health, accounting, or a related field
• Have at least 3 years of professional experience as an auditor, analyst, or within Medicaid program management

Responsibilities

• Conduct virtual audit interviews to evaluate risk areas, including but not limited to personal care services, managed care, provider enrollment, and non-emergency medical transportation
• Develop, maintain, and execute detailed audit plans to ensure comprehensive review and compliance assessment
• Analyze gathered information and documentation to evaluate compliance with state and federal regulations, summarizing findings in briefing documents for CMS in collaboration with policy analysts and subject matter experts (SMEs)
• Provide subject matter expertise on Medicaid and CHIP compliance, ensuring adherence to applicable policies, procedures, and state and federal regulations
• Collaborate with state agencies to collect necessary documentation and understand processes required to assess program compliance
• Prepare and deliver technical reports summarizing findings and recommendations following completion of audit reviews

Preferred Qualifications

• Have proven experience in technical writing and reporting
• Possess familiarity with CMS program integrity audits (Medicaid)
• Demonstrate the ability to conduct audit activities in accordance with established procedures and protocols with minimal supervision
• Possess strong teamwork skills to collaborate effectively in achieving review objectives, combined with the ability to work independently and make informed decisions
• Have in-depth knowledge of Medicaid terminology, acronyms, regulations, and policies
• Have professional experience assessing risk and evaluating functional capabilities
• Possess exceptional prioritization, organizational, and time management skills
• Be proficient in software applications, including Microsoft Office products
• Have a solid understanding of the audit and review process, including goals and objectives

Benefits

• Competitive compensation with opportunities for bonuses
• Employer paid health care
• Training and development funds
• 401k match