Medicare Program Integrity Advisor

Job Summary

Supporting the U.S. Department of Health and Human Services, the full-time remote Medicare/Medicaid Program Integrity Advisor will develop educational materials, analyze fraud vulnerabilities, and ensure compliance with CMS guidance and regulations.

Key responsibilities:

• Review peer submissions for quality and compliance with CMS regulations
• Serve as a subject matter expert on Program Integrity initiatives and provide expert consultation
• Develop and update educational content, including courses and outreach materials, to address emerging fraud schemes

Required qualifications:

• Minimum of 5 years of experience supporting Medicare, Medicaid, or healthcare Program Integrity initiatives
• Thorough understanding of CMS Program Integrity regulations and related federal requirements
• Bachelor's degree
• Proficient in Microsoft Office Applications, with advanced knowledge of Excel preferred
• Demonstrated expertise in CMS Program Integrity operations and policy