Medicaid Fraud Subject Matter Expert – Catapult Consultants

Catapult Consultants is now hiring a Medicaid Fraud Subject Matter Expert. The expert will Develop Medicaid and Medicare-Medicaid (Medi-Medi) proactive data analysis for identification of fraud schemes and trends. Provide subject matter expertise and technical assistance on matters related to Medicaid policies and regulations.  Support the Data Analysis, Medical Review, Program Integrity and Request for Information teams by consulting with staff and participating in investigative and/or data analysis efforts. 

Key Responsibilities:

  • Identification of proactive data studies in the Medicaid program, resulting in identification of high ROI fraud schemes
  • Remain informed of current Medicaid fraud and abuse issues/schemes through researching reports such as CMS MIG Reviews, OIG State Reports, National Association of Medicaid Directors (NAMD) Briefs and other resources included in the Medicaid SME Research list
  • Identify and document state program vulnerabilities
  • Attend Medi-Medi meetings with external customers
  • Ensure confidentiality of all PHI and sensitive information
  • Travel as required for meetings or training
  • Perform other duties as assigned

Basic Qualifications:

  • High proficiency level with Microsoft Excel and Word
  • Working knowledge of Microsoft PowerPoint
  • Excellent verbal and written communication skills
  • Excellent research skills including internet research
  • Ability to work independently with minimal supervision
  • Ability to perform multiple priority tasks
  • Associate must have and maintain a valid driver’s license issued by his/her state of residence

Preferred Qualifications:

  • A minimum of three years of Medicaid experience is required, program integrity or medical review experience preferred
  • Preference given to those with experience in IL, IN, IA, KS, KY, MI, MN, MO, NE, OH, WI

Required Education:

  • BA or BS degree preferred
  • Preference given to candidates with Certified Fraud Examiner (CFE) and/or Accredited Healthcare Fraud Investigator (AHFI) designations


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