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Medicaid Program Audit Manager

Windsor Mill, MD
Analytica is seeking a Medicaid Program Audit Manager to provide leadership on a Medicaid program integrity audit review and analytics program. The ideal candidate should have a deep understanding of Medicaid / Medicare with experience in (1) program integrity monitoring; (2) federal oversight of state Medicaid managed care programs and technical assistance to support improvements (3) comprehensive fraud risk assessment methodologies and practices; and (4) complex data analysis and communication abilities.

Primary Responsibilities may include:
  • Provide valuable insights and expertise to projects on Medicaid policy and programs and Program Integrity initiatives
  • Responsible for overall performance and success of program, that may include overseeing a range of concurrent analytic, audit and compliance project teams (each with 1-5 FTEs)
  • Ensure each project delivers within the constraints of quality, scope, schedule, and budget assigned to project
  • Act as the primary client engagement manager, including leading customer interaction, managing progress communications, resolving any potential issues, mitigating risks, develop, organize, and manage risks, action items, change control, and communication plans
  • Support state stakeholder communications and engagement, ensuring objectives and approach align to each state's unique Medicare policy and requirements
  • Enable and harness team’s skills and talents to successfully accomplish PI reviews and analytics within budget and timelines
  • Support identification of program or other opportunities to improve or expand support activities, including participating in business development, proposal development, opportunity identification, and solution sessions and client meetings
  • Identify and cultivate areas for improved support and growth of engagements across Medicaid and Medicare Program Integrity
  • 5+ years in a role at either state or federal-level supporting Medicaid / Medicare Program Integrity initiatives
  • 7+ years in management capacity or with Project Management experience where responsible for managing complex systems and workflows
  • Bachelor’s degree required; Masters degree a plus
  • CPA or Certified Fraud Examiner (CFE) Certification a plus
  • Strong Medicaid program and policy background with experience at the federal and/or state level
  • Strong Medicaid program integrity background with oversight experience at the federal and/or state level
  • Medicaid program integrity subject-matter and analytics expertise, ideally including managed care program integrity or oversight experience
  • Program Audit oversight expertise, including conducting risk and vulnerability assessments of government programs
  • Ability to work in a fast-paced, small business environment that may entail cross functional support and late nights or weekends when required
  • Strong written, communication and leadership skills

About ANALYTICA: Analytica is a leading consulting and information technology solutions provider to public sector organizations supporting health, civilian, and national security missions. Founded in 2009 and headquartered in Bethesda, MD, the company is an established SBA certified HUBZone and 8(a) small business that has been recognized by Inc. Magazine each of the past three years as one of the 250 fastest-growing companies in the U.S.  Analytica specializes in providing software and systems engineering, information management, analytics & visualization, agile project management, and management consulting services. The company is appraised by the Software Engineering Institute (SEI) at CMMI® Maturity Level 3 and is an ISO 9001:2008 certified provider.

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