Nurse Analyst/Investigator

General Dynamics Information Technology

Nurse Analyst/Investigator supporting CMS activities at GDIT. Interacting with stakeholders in fraud prevention with a focus on Medicare and Medicaid systems.

Posted 6/19/2026full-timeRemote • Maryland • 🇺🇸 United StatesSeniorLead💰 $93,500 - $126,500 per yearWebsite

About the role

Key responsibilities & impact

Support Centers for Medicare & Medicaid Services (CMS) activities at Baltimore, Maryland
Interact with staff and leaders in the FPS program, both within GDIT and with other entities working on FPS
Write and review edit proposals and consult with others regarding policy, medical coding, and clinical questions
Receive and reply to CMS urgent requests for information related to edits and other ad hoc program integrity requests
Review CMS policy and regulations to anchor support for new FPS edits and models
Identify new candidate topics for possible FPS edits and evaluate them by using data to identify risk and document CMS policy (e.g., LCD, NCD) that supports the edit

Requirements

What you’ll need

RN or LPN with 5+ years clinical experience
2+ years of experience in Medicare Program Integrity work at a MAC, UPIC or other program integrity contractor
2+ years of experience in medical coding with the corresponding appropriate professional certification(s) (e.g., CPC) or ability to attain certification within 12 months
Working knowledge of Medicare policy, processes and claims payment systems
Ability to pass CMS security clearance & background check
3 years of experience interacting with and consulting with others with a different background/expertise in a team environment
BA/BS/BSN
CPC certification
2+ years of experience working with Medicare Fee-for-Service pre-payment edits either in FPS, FISS, MCS, and/or VMS
Experience with Medicaid, Medicare Part C/D

Benefits

Comp & perks

Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts
Dental plan options
Vision plan
401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match
Full flex work weeks where possible
A variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave
15 days of paid leave per calendar year
10 paid holidays per year
Eligible employees can receive up to 160 hours of paid leave in a rolling 12 month period for family leave
Short and long-term disability benefits
Life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

medical codingprogram integritydata evaluationpolicy reviewrisk identificationclaims payment systemspre-payment editsclinical experienceMedicare Fee-for-ServiceMedicaid

Soft Skills

interpersonal communicationconsultationteam collaborationproblem-solvingadaptability

Certifications

RNLPNCPCBABSBSN