Job Description
📋 Description Identify fraud, waste, and abuse patterns in Medicaid home and community-based care data. Translate findings into scalable detection capabilities embedded in the platform. Collaborate with product and engineering to design detection dashboards and workflows. Present insights to state Medicaid agencies and internal stakeholders, guiding regulatory actions 🎯 Requirements Bachelor’s degree and 5+ years in healthcare fraud detection or related field. Knowledge of Medicaid operations and billing data. Ability to recognize FWA patterns and distinguish fraud, waste, and abuse. Strong analytical and investigative problem-solving skills; able to communicate to technical and Experience with multi-source data, ambiguous datasets, and data reconciliation. Willingness to work in evolving environments and explore AI tools responsibly. 🎁 Benefits Health plans, paid time off, holidays, 401K with company match. Equal opportunity employer commitment.
