Investigative Analyst – CMS Healthcare Claims

General Dynamics Information Technology

. Perform analytical tasks supporting the HFPP program .

Posted 10/8/2026full-timeRemote • United StatesSeniorLead💰 $77,775 - $105,225 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in health care claims analysis, with a strong focus on identifying fraud, waste, and abuse through data mining and analytics. Proficient in collaborating with partners and presenting findings to management-level staff while adhering to HIPAA regulations.

Highest-signal resume keywords

Health Care Claims AnalysisFraud DetectionData MiningMicrosoft Office SuiteTableau

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Health Care Claims AnalysisFraud DetectionData MiningAnalytic ReportingOutcome MetricsProvider Background ProfilesHIPAA ComplianceDecision-MakingOrganizational SkillsClinical Coding

Soft Skills

Oral CommunicationWritten CommunicationInterpersonal SkillsPrioritizationTeam Collaboration

Tools & Technologies

TableauAmazon WorkSpacesJiraConfluence

Certifications & Qualifications

Certified Fraud Examiner (CFE)Accredited Healthcare Fraud Investigator (AHFI)

Industry Keywords

Healthcare FraudWasteAbuseCMSTrusted Third Party

Tech Stack

Tools & technologies

Tableau

About the role

Key responsibilities & impact

Perform analytical tasks supporting the HFPP program
Identify fraud, waste, and abuse referrals and leads from HFPP Analytics
Conduct data mining across the partnership using internal tools
Collaborate on HFPP analytic reports
Develop fraud, waste, and abuse referrals and leads for Partners based on analytic reports
Drive outcome metrics related to referrals and leads shared with Partners
Interact regularly with Partners regarding identified referrals and leads
Support business development activities, including analyzing health claims data, generating study referrals and leads, developing provider background profiles, and identifying opportunities for Partner collaboration meetings
Support CMS and the Trusted Third Party in reducing healthcare fraud, waste, and abuse

Requirements

What you’ll need

BA/BS or equivalent experience
8+ years of experience in health care claims analysis
Strong oral and written communication skills with the ability to present to management-level staff
Expert-level knowledge of Microsoft Office suite
Experience with Tableau, Amazon WorkSpaces, Jira, and Confluence
Working knowledge of HIPAA privacy and security rules
Strong decision-making, organizational, prioritization, and interpersonal skills
Ability to independently follow through on problems
Ability to work on complex projects with general direction and minimal guidance
Ability to work effectively both independently and in a team environment
Work visa sponsorship will not be provided
Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud Investigator (AHFI) designation strongly desired
Certified clinical coding preferred

Benefits

Comp & perks

Comprehensive medical plan options, including plans with Health Savings Accounts
Dental plan options
Vision plan
401(k) plan with company match
Full-flex work weeks
Paid time off, including vacation, sick, personal, holiday, parental, military, bereavement, and jury duty leave
Typically 15 days of paid leave per calendar year
10 paid holidays per year
Up to 160 hours of paid family leave in a rolling 12-month period for eligible employees
Short- and long-term disability benefits
Life insurance
Accidental death and dismemberment insurance
Personal accident insurance
Critical illness insurance
Business travel and accident insurance
Growth tool identifying career steps and learning opportunities
Internal mobility support
Wellness packages
Award-winning culture of innovation
Military-friendly workplace