Program Integrity Analyst III

Qlarant

Program Integrity Analyst specializing in healthcare program integrity and fraud vulnerability reporting. Collaborating with internal and external professionals to drive project execution and reporting accuracy.

Posted 6/16/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $78,216 - $112,584 per yearWebsite

About the role

Key responsibilities & impact

Works with a team of internal and external professionals as a subject matter expert
Participates in planning and execution of team projects, assisting with setting strategic goals
Implements processes and uses necessary tools to enhance project execution and drive consistent performance improvements
Conducts research of program areas/topics defined by management; participates in internal and external focus groups
Utilizes experience to identify appropriate reports, rules, and regulations for drafting vulnerability reports
Meets regularly with teams to discuss current and future projects; advises teams and management
Contributes to final written product presented to stakeholders; proofreads written products of team members
Serves as a productive member of external and internal teams to ensure all deadlines for deliverables are met
Briefs management on projects, including completion timelines and potential difficulties
Provides clinical input as a Subject Matter Expert for program integrity and program vulnerability
Identifies and mitigates risks proactively, implementing strategies to ensure continuity of project execution
Participates in project reporting and performance analysis, ensuring accuracy of project data

Requirements

What you’ll need

Bachelor's Degree required
5 - 7 years required; 8 - 11 years preferred
RN preferred
Experience in Medicaid coding, billing, auditing, and compliance from a state or federal perspective
Medicaid program integrity auditing experience is preferred
Experience locating and interpreting publicly available Medicaid information to identify relevant potential program vulnerabilities

Benefits

Comp & perks

🌐 Worldwide ❌ Jobs You've Hidden ⭐️ Saved Jobs ✅ Applied Jobs ✉️ Email Alerts 👤 Account Qlarant Website LinkedIn All Job Openings 501 - 1000 employees Founded 1973 🏛️ Government ⚕️ Healthcare Insurance Government
Healthcare Insurance
Insurance & Financial Services Qlarant is a US-based services and technology firm specializing in healthcare program integrity, offering quality improvement, fraud, waste & abuse (FWA) detection and investigative services, and advanced data analytics and predictive modeling tools (the RIViR® Risk Solution Suite) for government agencies, health plans, and related sectors. The company also operates initiatives like the Qlarant Foundation and Qlarant Capital to fund grants and early-stage startups, and provides pharmacy, drug pricing, and transportation-focused solutions. Program Integrity Analyst III 🔥 21 minutes ago 🇺🇸 United States – Remote 💵 $78.2k - $112.6k / year ⏰ Full Time 🟡 Mid-level 🟠 Senior 🧐 Analyst Apply Now Find Hiring Managers Customize resume + cover letter Report problem ☆ Save ☑️ Mark as applied ❌ Hide 📋 Description
Works with a team of internal and external professionals as a subject matter expert
Participates in planning and execution of team projects, assisting with setting strategic goals
Implements processes and uses necessary tools to enhance project execution and drive consistent performance improvements
Conducts research of program areas/topics defined by management; participates in internal and external focus groups
Utilizes experience to identify appropriate reports, rules, and regulations for drafting vulnerability reports
Meets regularly with teams to discuss current and future projects; advises teams and management
Contributes to final written product presented to stakeholders; proofreads written products of team members
Serves as a productive member of external and internal teams to ensure all deadlines for deliverables are met
Briefs management on projects, including completion timelines and potential difficulties
Provides clinical input as a Subject Matter Expert for program integrity and program vulnerability
Identifies and mitigates risks proactively, implementing strategies to ensure continuity of project execution
Participates in project reporting and performance analysis, ensuring accuracy of project data 🎯 Requirements
Bachelor's Degree required
5 - 7 years required; 8 - 11 years preferred
RN preferred
Experience in Medicaid coding, billing, auditing, and compliance from a state or federal perspective
Medicaid program integrity auditing experience is preferred
Experience locating and interpreting publicly available Medicaid information to identify relevant potential program vulnerabilities Apply Now 📊 Check your resume score for this job Improve your chances of getting an interview by checking your resume score before you apply. Check Resume Score Similar Jobs Senior Total Rewards Analyst 🔥 1 hour ago Sumitomo Pharma America, Inc. 1001 - 5000 🧬 Biotechnology 💊 Pharmaceuticals ⚕️ Healthcare Insurance Website LinkedIn All Job Openings Senior Analyst in Total Rewards at Sumitomo Pharma analyzing and optimizing benefits programs to enhance employee engagement. Collaborating across departments to streamline administration and compliance. 🇺🇸 United States – Remote 💵 $99.5k - $124.4k / year ⏰ Full Time 🟠 Senior 🧐 Analyst Clinical Programs Analyst 🔥 1 hour ago DaVita Kidney Care 10,000+ employees ⚕️ Healthcare Insurance Website LinkedIn All Job Openings Analyst supporting DaVita's Integrated Kidney Care initiatives focusing on clinical quality and data analysis. Managing care gaps and collaborating with payor partners to enhance patient experiences. 🇺🇸 United States – Remote 💵 $57.8k - $85k / year 💰 Post-IPO Debt on 2021-02 ⏰ Full Time 🟡 Mid-level 🟠 Senior 🧐 Analyst Epic Analyst II 🔥 1 hour ago DaVita Kidney Care 10,000+ employees ⚕️ Healthcare Insurance Website LinkedIn All Job Openings Epic Analyst II handling implementation and support of Epic modules for nephrology practices. Collaborating with clinical and administrative users to ensure effective technology use. 🇺🇸 United States – Remote 💵 $70k - $106k / year 💰 Post-IPO Debt on 2021-02 ⏰ Full Time 🟡 Mid-level 🟠 Senior 🧐 Analyst Clinical Analyst – Outpatient Methodology Groupers 🔥 2 hours ago Solventum 10,000+ employees ⚕️ Healthcare Insurance 📚 Education 🧘 Wellness Website LinkedIn All Job Openings Clinical Analyst designing and maintaining methodologies for outpatient healthcare at Solventum. Responsibilities include validation of healthcare data and collaboration for software enhancement. 🇺🇸 United States – Remote 💵 $96k - $132k / year ⏰ Full Time 🟡 Mid-level 🟠 Senior 🧐 Analyst Senior Business Configuration Analyst 🔥 5 hours ago Community Health Options 51 - 200 ⚕️ Healthcare Insurance Website LinkedIn All Job Openings Senior Business Configuration Analyst at Community Health Options bridging technical solutions and business team needs. Involves requirement gathering, documentation, system configuration, and stakeholder collaboration. 🇺🇸 United States – Remote ⏰ Full Time 🟠 Senior 🧐 Analyst View More Analyst Jobs 🌐 Worldwide Built by Lior Neu-ner. I'd love to hear your feedback — Get in touch via DM or support@remoterocketship.com Search Search Jobs by country Search jobs by city Search jobs by job title Search entry-level jobs Search junior-level jobs Search senior-level jobs Search jobs by tech stack Search jobs by contract type Search remote internships Search remote part-time jobs Remote jobs Anywhere in the World Companies Hiring Anywhere in the World Companies Hiring Sales People Anywhere in the World Companies Hiring Software Engineers Anywhere in the World Resources Advice Tips for finding remote jobs Interview questions and answers Resume examples Cover letter examples Post a job Affiliates Privacy policy Terms of service Job board SEO course AI Apply Copilot OpenClaw job finder Jobs by Country Remote jobs anywhere in the world (Worldwide remote jobs) Remote jobs United States Remote jobs Australia Remote jobs Brazil Remote jobs Canada Remote jobs France Remote jobs Ireland Remote jobs Germany Remote jobs Netherlands Remote jobs Spain Remote jobs UK Popular Jobs Remote data analyst jobs Remote customer support jobs Remote executive assistant jobs Remote marketing jobs Remote product designer jobs Remote product manager jobs Remote project manager jobs Remote recruiter jobs Remote sales jobs Remote software engineer jobs Jobs by Type Remote full-time jobs Remote part-time jobs Remote contract jobs Remote internship jobs Remote entry-level jobs Remote jobs with no experience required Remote junior jobs (1-3 years of experience) Digital nomad jobs Remote jobs with no degree required Freelance remote jobs Temporary remote jobs Remote jobs hiring now Stay at home mom jobs

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Hard Skills & Tools

Medicaid codingbillingauditingcomplianceprogram integrity auditingvulnerability reportingperformance analysisrisk mitigationdata accuracy

Soft Skills

team collaborationstrategic planningcommunicationproofreadingadvisingproject managementproblem-solvingresearchstakeholder engagement

Certifications

Bachelor's DegreeRN