Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Healthcare Fraud, Waste, and Abuse SME

$89.25k - $120.75k
Full-time

Gdit

Type of Requisition: Regular

Clearance Level Must Currently Possess:

None

Clearance Level Must Be Able to Obtain:

None

Public Trust/Other Required:

None

Job Family:

Program Instruction Support

Job Qualifications:

Skills:

Collaboration, Investigations, Planning, Presentations, Training and Development

Certifications:

None

Experience:

5 + years of related experience

US Citizenship Required:

No

Job Description:

Make meaningful contributions that fuel critical outcomes for some of the most complex government, defense, and intelligence projects. Join GDIT as a Healthcare Fraud, Waste and Abuse (FWA) Subject Matter Expert (SME) for a career where your growth is just as important as the mission you support.

As a Healthcare FWA SME, the work you’ll do at GDIT will be impactful to the mission of the Centers for Medicare & Medicaid Services (CMS). You will play a crucial role in supporting state Medicaid agencies' program integrity efforts as a member of the Medicaid Integrity Institute (MII) team.

***Work visa sponsorship will not be provided for this role.

MEANINGFUL WORK AND PERSONAL IMPACT:

  • Support MII as a FWA content expert and curriculum contributor to develop relevant, high-quality training materials for Medicaid program integrity professionals, including investigators, analysts, and auditors.

  • Collaborate with Medicaid investigators and state program integrity staff to understand training needs, skill gaps, and the types of topics they want to learn more about.

  • Drive training engagement by ensuring all materials are well-organized, accurate, and designed to support investigator development.

  • Utilize your investigative skillset to research emerging FWA trends, recommend high-value topics, develop presentation concepts, and draft slide decks that support MII's mission to deliver practical, timely, and impactful training.

WHAT YOU’LL NEED TO SUCCEED:

  • Bachelor’s degree (BA/BS) in a related field

  • Minimum of 5 years of relevant experience within healthcare program integrity, Medicaid operations, or investigative roles focused on fraud, waste, and abuse.

  • Prior work with state Medicaid agencies or federal program integrity programs and experience developing training materials or presenting in educational settings.

  • Demonstrated experience working with state Medicaid agencies, CMS, or other federal program integrity initiatives.

  • Proven ability to develop training content, deliver presentations, or facilitate instruction for professional audiences.

  • Familiarity with investigative tools, data sources, and methodologies commonly used in FWA detection and analysis.

  • Knowledge of healthcare FWA concepts, schemes, trends, and investigative approaches.

  • Strong communication and storytelling skills, with the ability to transform complex policy, regulatory, and investigative topics into clear, actionable training materials.

  • Ability to collaborate effectively with subject matter experts, investigators, and state program integrity staff to identify needs and shape curriculum.

GDIT IS YOUR PLACE:

  • At GDIT, the mission is our purpose, and our people are at the center of everything we do.

  • Growth: AI-powered career tool that identifies career steps and learning opportunities.

  • Support: An internal mobility team focused on helping you achieve your career goals.

  • Rewards: Comprehensive benefits and wellness packages, 401K with company match, and competitive pay and paid time off.

  • Flexibility: Full-flex work week to own your priorities at work and at home.

  • Community: Award-winning culture of innovation and a military-friendly workplace.

OWN YOUR OPPORTUNITY:

Explore a career at GDIT and you’ll find endless opportunities to grow alongside colleagues who share your ambition to deliver your best work.

The likely salary range for this position is $89,250 - $120,750. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.

Scheduled Weekly Hours:

40

Travel Required:

10-25%

Telecommuting Options:

Remote

Work Location:

Any Location / Remote

Additional Work Locations:

Total Rewards at GDIT:

Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 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. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. GDIT typically provides new employees with 15 days of paid leave per calendar year to be used for vacations, personal business, and illness and an additional 10 paid holidays per year. Paid leave and paid holidays are prorated based on the employee’s date of hire. The GDIT Paid Family Leave program provides a total of up to 160 hours of paid leave in a rolling 12 month period for eligible employees. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most.

Our Identity Verification Process:

As part of the hiring process, we will ask you to complete an identity verification process that leverages advanced biometrics and artificial intelligence to ensure authenticity and protect against identity fraud. You are expected to be on camera during virtual interviews. We reserve the right to take your picture to verify your identity and prevent fraud. By proceeding, you authorize the collection, processing, and use of your biometric data for identity verification and security purposes.

About Our Work:

We are GDIT. A global technology and professional services company that delivers technology solutions and mission services to every major agency across the U.S. government, defense and intelligence community. Our 26,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50+ countries worldwide, offering leading mission-ready capabilities in AI, cloud, cyber and software development.Join our Talent Community to stay up to date on our career opportunities and events at

gdit.com/tc.

Equal Opportunity Employer / Individuals with Disabilities / Protected Veterans
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Healthcare Fraud, Waste, and Abuse SME in Remote vacancy
  • $89.25k - $120.75k

     ...outcomes for some of the most complex government, defense, and intelligence projects. Join GDIT as a Healthcare Fraud, Waste and Abuse (FWA) Subject Matter Expert (SME) for a career where your growth is just as important as the mission you support. As a Healthcare FWA... 
    Fraud
    Full time
    Temporary work
    Immediate start
    Remote work
    Work from home
    Worldwide
    Flexible hours

    General Dynamics Information Technology

    Virginia
    4 days ago
  • $100k - $120k

     ...Position: Nurse Subject Matter Expert (SME) Location: Remote About J...  ...J29 is an employee centered healthcare management consulting company that specializes...  ...investigations, data analysis, healthcare reviews, fraud, waste, and abuse (FWA) prevention efforts. This... 
    Fraud
    Full time
    Contract work
    For contractors
    Remote work

    J29, Inc

    Millersville, MD
    6 days ago
  •  ...Humana Inc. is seeking a Fraud and Waste Professional 2 to coordinate investigations of fraudulent and abusive practices across internal and external entities, assemble evidence, and prepare complex investigative and audit reports in support of adjudication. This is a... 
    Fraud
    Remote work

    Humana

    Salt Lake City, UT
    3 days ago
  • $65k - $88.6k

     ...Healthcare Investigator Humana is looking for an experienced Healthcare Investigator to join its industry leading Special Investigations...  ...? But, most of all do you have a passion for combating Fraud, Waste, and Abuse in the Health Care Industry? If this resonates with you,... 
    Fraud
    Temporary work
    Work at office
    Local area
    Remote work
    Work from home
    Home office

    Humana

    United States
    4 days ago
  • $65k - $88.6k

     ...Become a part of our caring community The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud and Waste...  ...degree Minimum 2 years of experience in healthcare fraud investigations Knowledge of healthcare... 
    Fraud
    Bi-weekly pay
    Full time
    Temporary work
    Apprenticeship
    Work at office
    Remote work
    Work from home
    Home office
    Monday to Friday

    Humana

    Salt Lake City, UT
    3 days ago
  • $65k - $88.6k

    Become a part of our caring community The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud and Waste...  ...degree Minimum 2 years of experience in healthcare fraud investigations Knowledge of healthcare... 
    Fraud
    Bi-weekly pay
    Full time
    Temporary work
    Apprenticeship
    Work at office
    Remote work
    Work from home
    Home office
    Monday to Friday

    Humana

    Salt Lake City, UT
    5 days ago
  •  ...Conducting detailed investigations into potential fraud, waste, and abuse in healthcare claims, the full-time remote Special Investigator will review medical records and claims data, collaborate with internal teams, and prepare comprehensive reports for compliance and... 
    Fraud
    Full time
    Remote work

    Virtual Vocations Inc

    United States
    2 days ago
  • $80.06k - $106.06k

     ...Special Investigations Unit Investigator II (Healthcare) The SIU Investigator II is responsible for investigating and analyzing suspected cases of fraud, waste, and abuse within the healthcare environment. This role conducts comprehensive investigations, leveraging data... 
    Fraud
    Work experience placement
    Work from home
    Monday to Friday

    IEHP

    Rancho Cucamonga, CA
    1 day ago
  •  ...services Act as a patient advocate to ensure access to essential healthcare resources Collaborate with hospital teams on discharge...  ...Monitor utilization, quality, and compliance (including fraud, waste, and abuse) Participate in interdisciplinary meetings, quality... 
    Fraud
    Remote work
    Monday to Friday

    Medix

    Washington DC
    4 days ago
  • $225k - $275k

     ...as a coding and medical payment policy subject matter expert (SME). The CMD is responsible for directing the Medical Policy Committee...  ...on medical policy, medical coding, payment integrity and/or fraud/waste/abuse. Experience in clinical medicine. Adaptive capacity for... 
    Fraud
    Work at office
    Immediate start
    Remote work
    Work from home

    Cotiviti

    Eastern, KY
    4 days ago
  •  ...Join us in our mission to transform healthcare! nirvanaHealth (under RxAdvance Corp.)...  ...to sizably reduce the $1 trillion in waste in healthcare administrative and medical...  ...effectiveness and quality. Supports Fraud, Waste and Abuse (FWA) program system oversight and communicates... 
    Fraud

    RxAdvance

    Southborough, MA
    4 days ago
  •  ...Centene Corporation seeks an Investigator to conduct fraud, waste, and abuse investigations across healthcare programs. You will review referrals, claims data, and medical records, document findings, and support case resolution while ensuring regulatory and contractual... 
    Fraud
    Remote work

    Centene Corporation

    Raleigh, NC
    2 days ago
  •  ...Leading complex fraud investigations in healthcare billing, coding, and claims, the full-time remote Senior Fraud Investigator will analyze large...  ...Analyze large data sets to detect potential fraud, waste, and abuse in healthcare billing and claims Prepare detailed reports... 
    Fraud
    Full time
    Remote work

    Virtual Vocations Inc

    United States
    2 days ago
  •  ...and readiness to accept help and guidance. Serve as a substance abuse counselor to individuals, families, and groups. Assess and...  ...field of Substance Abuse, including current complexities of the healthcare industry. Considerable interpersonal skills as well as oral and... 
    Temporary work

    Vera French Community Mental Health Center

    Davenport, IA
    2 days ago
  • Centene Corporation seeks an investigator to conduct fraud, waste, and abuse investigations across healthcare data, records, and referrals. You will prepare case reports, coordinate with compliance and legal teams, and support program integrity efforts while ensuring regulatory... 
    Fraud
    Remote job
    Flexible hours

    Centene Corporation

    Phoenix, AZ
    5 days ago
  • $89.17k - $142.68k

     ...statistically sound audit support. This role combines advanced data analysis, dashboard development, healthcare claims expertise, and stakeholder engagement to identify fraud, waste, abuse, payment accuracy opportunities, and operational improvement initiatives.The analyst... 
    Fraud
    Full time
    Local area
    Remote work
    Flexible hours

    Blue Cross and Blue Shield of North Carolina

    Durham, NC
    1 day ago
  •  ...to quality care. With human-centered, healthcare-relevant, and value-based solutions, we...  ...assess the potential for overpayment or fraud. Using established criteria/ and clinical...  ...patterns suggestive of fraud, waste, or abuse Participate in provider education sessions... 
    Fraud
    Contract work
    For contractors
    Local area
    Remote work

    Commence Corporation

    Brooklyn, NY
    2 days ago
  •  ...Council Capital Job Opportunity Council Capital is a healthcare-focused private equity firm based in Nashville, Tennessee,...  ...integrity platform pairs analytics with expert review to surface fraud, waste, and abuse across Medicare, Medicaid, Commercial, and FEP lines of... 
    Fraud
    Remote work

    City of Groton

    United States
    3 days ago
  •  ...Healthcare Fwa InvestigatorLevels (Investigator, Sr. Investigator, etc) will depend on experience and qualifications.Integrity Advantage...  ...the detection, investigation and prevention of healthcare fraud, waste and abuse (FWA). We are growing and looking for dynamic, confident... 
    Fraud
    Remote work

    Integrity Advantage

    Toms River, NJ
    2 days ago
  •  ..., ethics, patient safety, privacy, and healthcare operations across one of the nation's leading...  ...and coding concernsFraud, waste, and abuse risksHIPAA privacy and security mattersWorkplace...  ...Privacy Compliance (CHPC)Certified Fraud Examiner (CFE)Comparable compliance or... 
    Fraud
    Work at office
    Remote work

    Acadia Healthcare

    Franklin, TN
    5 days ago
  •  ...and applications including Microsoft Office. Knowledge in healthcare systems operations and experience in navigating EMRs.Ability...  ...& CMS guidelines for Parts C & D on General Compliance and Fraud, Waste & Abuse.Complies with HR confidentiality standards.RequirementsEducation... 
    Fraud
    Work at office
    Shift work

    Advanced Urology Institute

    Oxford, FL
    2 days ago
  •  ...natural supports, treatment team members, healthcare providers, schools, community...  ...suicidal ideation, homicidal ideation, abuse, neglect, exploitation, significant safety...  ...policies and procedures.Report suspected fraud, waste, abuse, ethical violations, safety concerns... 
    Fraud
    Immediate start
    Work from home
    Trial period

    WATSON COMMUNITY HEALTH CENTRE

    Cincinnati, OH
    21 days ago
  • $170k - $220k

     ...committed to pioneering innovative technology solutions in civic healthcare. Our dedication lies in making a meaningful impact on...  ...(CMS) is enhancing program integrity efforts to combat fraud, waste, and abuse within Medicare and Medicaid. The Unified Case Management... 
    Fraud
    Contract work
    Temporary work
    For contractors
    Remote work
    Work from home
    Flexible hours

    Bellese

    United States
    5 days ago
  •  ...payment accuracy, affordability, provider collaboration, and healthcare quality. This is an opportunity to help establish and...  ...judgment and interpretation. Support efforts to prevent fraud, waste, and abuse while ensuring fair and accurate reimbursement practices.... 
    Fraud
    Work at office
    Remote work

    Independence

    Philadelphia, PA
    19 days ago
  •  ...'s Federal Health Division is hiring a Healthcare Coding Expert to support the Centers for...  ...leads and referrals for the Healthcare Fraud Prevention Partnership (HFPP) members (...  ...established in 2012 to reduce fraud, waste and abuse in healthcare data. Work expected... 
    Fraud
    Work experience placement
    Work at office

    General Dynamics Information Technology

    Remote
    28 days ago
  • $150k - $165k

     ...participating in calibration sessions, identifying trends (including fraud, waste, and abuse), and supporting workflow improvements You'll start...  ...coverage. ~ Flexible Spending Accounts for healthcare and dependent care expenses. ~ Voluntary benefit programs... 
    Fraud
    Immediate start
    Remote work
    Flexible hours

    Liberty Dental Plan

    Tustin, CA
    1 day ago
  •  ...environment within a correctional facility, jail-based substance abuse treatment program, or a community-based substance treatment...  ...and written communication with team members, clients and other healthcare providers. Ability to recognize co-occurring disorders and make... 
    Work at office
    Immediate start

    GovernmentJobs.com

    Graham, NC
    4 days ago
  • $25 - $28 per hour

     ...Sr. Compliance Specialist FreedomCare is a healthcare company that has been dedicated to revolutionizing the home care industry...  ...and responding to internal/external audits, investigating Fraud, Waste & Abuse claims. The Compliance Specialist role will encompass a wide... 
    Fraud
    Remote work

    FREEDOM CARE , LLC

    United States
    4 days ago
  •  ...and applications including Microsoft Office. Knowledge in healthcare systems operations and experience in navigating EMRs.Ability...  ...& CMS guidelines for Parts C & D on General Compliance and Fraud, Waste & Abuse.Complies with HR confidentiality standards.RequirementsEducation... 
    Fraud
    Work at office
    Shift work
    Weekend work
    Afternoon shift

    Integrated Medical Professionals, PLLC

    Smithtown, NY
    2 days ago
  • $110k - $130k

     ...a Data Scientist to support a federal program focused on healthcare program integrity. This role operates within a remote environment...  ...for analyzing Medicare and Medicaid data to detect fraud, waste, and abuse. The position requires experience supporting healthcare data... 
    Fraud
    Work experience placement
    Remote work

    Blu Omega

    United States
    1 day ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Healthcare Fraud, Waste, and Abuse SME. Be the first to apply!