Program Integrity Auditor

Analytica is seeking a Program Integrity Auditor to support an initiative aimed at enhancing the integrity and accountability of Medicaid programs across the United States. The Program Integrity Auditor position will focus on conducting comprehensive program integrity audits for Medicaid programs across multiple states. This role is critical to ensuring compliance with federal and state regulations, identifying vulnerabilities, and preventing fraud, waste, and abuse. The auditor will assess adherence to program policies and procedures. This position requires a high level of client engagement, including direct interaction with state Medicaid agencies, CMS representatives, and other stakeholders. Auditors must be comfortable presenting findings, preparing detailed reports, and offering recommendations to address identified vulnerabilities. Regular communication, collaboration, and responsiveness are key to building trust and ensuring successful project outcomes.
Analytica has been recognized by Inc. Magazine as a fastest-growing private US small business. We work with U.S. government customers in health, civilian, and national security missions. Analytica offers competitive compensation with opportunities for bonuses, employer paid health care, training and development funds, and 401k match.
 
Responsibilities include (but not limited to): 

• 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.

Minimum Qualifications:

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

Preferred Qualifications:

• Proven experience in technical writing and reporting.
• Familiarity with CMS program integrity audits (Medicaid) is preferred.
• Demonstrated ability to conduct audit activities in accordance with established procedures and protocols with minimal supervision.
• Strong teamwork skills to collaborate effectively in achieving review objectives, combined with the ability to work independently and make informed decisions.
• In-depth knowledge of Medicaid terminology, acronyms, regulations, and policies.
• Professional experience assessing risk and evaluating functional capabilities.
• Exceptional prioritization, organizational, and time management skills.
• Proficiency in software applications, including Microsoft Office products.
• Solid understanding of the audit and review process, including goals and objectives.

About Analytica: Analytica is a leading consulting and information technology solutions provider to public sector organizations supporting health, civilian, and national security missions. The company is an award-winning SBA certified 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.