Overview Peraton is a next-generation national security company that drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world’s leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies. Peraton operates at the critical nexus between traditional and nontraditional threats across all domains: land, sea, space, air, and cyberspace. The company serves as a valued partner to essential government agencies and supports every branch of the U.S. armed forces. Each day, our employees do the can’t be done by solving the most daunting challenges facing our customers. Visitperaton.comto learn how we’re keeping people around the world safe and secure. Responsibilities SafeGuard Services (SGS), a subsidiary of Peraton, performs audits, investigations, data analysis, and medical reviews to detect, prevent, deter, reduce fraud, waste, and abuse.We are looking to add aMedicaid Fraud AuditorTeam Lead to our SGS team of talented professionals.This is a remote position, candidates must reside within the Northeast Jurisdiction which include the states of Maine, Vermont, New Hampshire, Massachusetts, Rhode Island, Connecticut, New York, Pennsylvania, New Jersey, Delaware, Maryland, and the District of Columbia.What You’ll do:As an Audit Team Lead, this individual’s primary responsibilities include achieving quality objectives, providing day-to-day workload oversight to promote timely development and resolution of Medicaid audits and providing mentoring and guidance to Audit team members.  The individual exercises significant independent judgment within broadly defined policies and practices to determine the best method for accomplishing work and achieving objectiveswithin established timelines.Oversee the development and progression of audits from initiation through completion, including planning, audit testing, analysis, findings, provider communications, and issuance of final finding reports.Provide day-to-day oversight and direction for assigned Auditors conducting Medicaid audits. The Team Lead is responsible for ensuring that audits are appropriately planned, progressed, documented, reviewed, and completed in accordance with applicable federal and state Medicaid requirements, established audit methodologies.Provide technical guidance and consultation to Auditors regarding Medicaid requirements, audit methodology, regulatory interpretation, claims analysis, documentation, and development of findings.Review individual workload during monthly auditor meetings; assist with prioritizing and conduct QC for staff.Establish priorities and monitor staff workloads to ensure resources are appropriately aligned with audit requirements and metrics.Monitor the quality of WMM/UCM.Monitor timeliness for audit updates and escalate to management as necessary.Mentor team members so that they can identify previously undetected fraud, waste, or abuse through proactive or reactive research, analysis, and development.Act as a point of contact for manager.Essential Functions Include:Ability to perform research and draw conclusionsAbility to present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the GovernmentAbility to organize a case file, accurately and thoroughly document all steps takenAbility to compose correspondence, reports and referral summary lettersAbility to educate providers, provider associations, law enforcement, other contractors and beneficiary advocacy groups on program safeguard mattersAbility to communicate effectively, internally and externallyAbility to interpret laws and regulationsAbility to exercise independent judgment while working within established policies, procedures, and audit methodologies.Ability to work with staff managing multiple assignments, establishing priorities, meeting deadlines, and maintaining accurate audit documentation.Ability to handle confidential materialAbility to report work activity on a timely basisAbility to work independently and as a member of a team to deliver high-quality workAbility to attend meetings, training, and conferences, overnight travel requiredDocument QC results in WMM according to record typeCoordinate with other designated leads, if necessary, for coverage for periods where the lead is out of the office during work hours. Qualifications Basic Qualifications:Minimum of 8 years with BS/BA; or 12 years with a HS Diploma/equivalentExperience conducting Medicaid, Medicare, healthcare, compliance, financial, internal, or program integrity audits.Experience leading staff in identifying and documenting noncompliance, improper payments, billing irregularities, or potential overpayments.Strong written, verbal communication and organization skills.Strong PC knowledge and Microsoft Office tools.US CitizenDesirable Qualifications:Direct Medicaid audit or Medicaid Program Integrity experience.Experience researching and applying state-specific Medicaid requirements.Experience auditing hospitals, pharmacies, laboratories, physicians, dental providers, behavioral health providers, personal care providers, managed care organizations, or other Medicaid provider types.Experience with Medicaid provider compliance and billing requirements.Experience identifying Medicaid overpayments.Professional certification such as CPA, CIA, CFE, CHC, CPC, or a comparable audit, fraud, healthcare, or compliance credential preferred.