California Licensed Research Analyst

To support critical provider and client-focused programs, the full-time California Licensed Research Analyst will lead a team in investigating prepayment fraud, waste, and abuse, while working in a hybrid environment that combines remote and occasional in-office duties. Key responsibilities Provide functional leadership and guidance to the research analyst team in resolving inquiries related to fraud, waste, and abuse Gather and document supporting evidence for medical consultant reviews, ensuring timely and accurate case documentation Collaborate with cross-functional teams to investigate leads and ensure compliance with organizational policies and regulatory requirements Required qualifications Three or more years of experience in healthcare operations, claims processing, or a related field; Medi-Cal experience preferred Demonstrated experience in a functional lead role with strong analytical and decision-making skills Excellent written and verbal communication skills for effective collaboration with stakeholders Experience in assessing business processes and identifying opportunities for improvement Working knowledge of healthcare regulations and claims processing systems Virtual Vocations Inc