Medicaid Program Integrity Analyst

Job Summary

Assisting the Program Integrity Analyst II and Program Integrity Supervisor, the full-time Medicaid Program Integrity Analyst will process administrative actions, manage lead entries, and contribute to identifying and eliminating fraud, waste, and abuse in a remote work environment.

Key responsibilities

• Enters new leads for analysis and potential escalation to Medicare or Medicaid teams
• Submits payment suspension activation requests and manages related documentation
• Monitors revocations workload and serves as a mentor to new Program Integrity staff

Required qualifications

• High School Diploma or G.E.D equivalent
• 1-5 years of related experience
• Working knowledge of AdvanceTrack and UCM or similar inventory management systems
• Effective time management and prioritization skills
• Ability to work independently and manage multiple assignments