Analyst, Compliance, Fraud, Waste & Abuse - Military veterans preferred

Position Title: Analyst, Compliance, Fraud, Waste & Abuse

Location: Commerce, CA 90040

Description:

Grow Healthy

If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day.

Job Overview

The Compliance Fraud, Waste & Abuse Analyst is responsible for supporting the prevention, detection, investigation, reporting, and related to health care fraud, waste, and abuse. This role is responsible for reviewing and analyzing information to draw conclusions on allegations of FWA and recommend appropriate action. Conducts both preliminary assessments of FWA allegations determining whether the investigation and/or audit identified potential fraud, waste, or abuse, and end-to-end full investigations, findings identification and communications development, and recommendations and preparation of overpayment identifications and closure of investigative cases. Activities include: identifying areas of investigation, collecting, analyzing, and interpreting data, spotting trends, and writing reports and recommendations for internal and/or external stakeholders. The position works collaboratively with the program lead and internal departments, including the Office of General Counsel, Medical Director (s), and subsidiary organizations to achieve and maintain appropriate enterprise anti-fraud program effectiveness.

Minimum Requirements

• An Associate's or Bachelor's degree is preferred

• A minimum of 1 year of experience as an FWA analyst/investigator is required.

• Experiences conducting data mining in the healthcare insurance industry and claims-related experience.

• Knowledge of coding, reimbursement, and claims processing policies

• Knowledge of the law and regulations as it relates to fraud and fraud investigations.

Compensation

$68,640.00 - $85,800.00 annually

Compensation Disclaimer

Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives.

Benefits & Career Development

• Medical, Dental and Vision insurance
• 403(b) Retirement savings plans with employer matching contributions
• Flexible Spending Accounts
• Commuter Flexible Spending
• Career Advancement & Development opportunities
• Paid Time Off & Holidays
• Paid CME Days
• Malpractice insurance and tail coverage
• Tuition Reimbursement Program
• Corporate Employee Discounts
• Employee Referral Bonus Program
• Pet Care Insurance

Job Advertisement & Application Compliance Statement

AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.

Remote Type: Hybrid


About US: As the nation’s largest Federally Qualified Health Center (FQHC), AltaMed is at the forefront of providing affordable, high-quality health care to underserved communities in Los Angeles and Orange Counties. At AltaMed, you will have the opportunity to work with a diverse team of dedicated professionals who are passionate about making a difference and supporting our community of over 400,000 patients.

Learn About AltaMed: Click Here

AltaMed Health Services Corporation is committed to providing equal employment opportunities for all qualified individuals. We strictly prohibit discrimination in employment based on race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin, age, medical condition, physical or mental disability, military or protected veteran status, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical conditions, genetic information, or any other characteristic protected by local, state, or federal law, ordinance, or regulation.

We are committed to promoting equality and inclusivity beyond our recruitment and hiring processes. We aim to create a respectful, valued, and inclusive workplace through training, advancement opportunities, and access to resources and support. We focus on fostering a diverse workforce because it enriches our organization and improves our ability to effectively serve our clients and community. We encourage individuals from all backgrounds to apply and join us in our mission to create a positive impact.

Equal employment opportunity, including veterans and individuals with disabilities.

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