Medicaid Program Integrity Analyst

We need to output HTML fragment with sections: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections that have real specific content. Must not repeat job title. No metadata like Job ID. Remove boilerplate like EEO, etc. Must preserve all substantive info. We need to parse the posting. Key sections: Overview: description of role, responsibilities, etc. We need to decide headings: "About the role" maybe for overview. "Responsibilities" for duties. "Requirements" maybe for required qualifications. "Qualifications" maybe for preferred qualifications. "Skills" maybe for tools and competencies. "Benefits" from BerryDunn Benefits & Culture. "Pay" from Compensation Details. "Schedule" maybe from work location and travel expectations? The posting includes work location flexibility, travel expectations 30-50%, availability during HST. That could be schedule? Not exactly schedule but maybe "Work Location & Travel". However schedule heading only if posting actually states schedule (like hours). It says "Regardless of location, the role requires availability during Hawaii Standard Time (HST) working hours." That's schedule info. So we can include Schedule section. We must not include placeholder text like "commensurate with experience". Not present. We need to extract content. Let's extract: About the role: The overview paragraph(s) describing role: "BerryDunn is seeking a Medicaid Program Integrity Analyst to support Hawaiʻi Med-QUEST's (MQD) Third Party Liability (TPL) Unit and Program Integrity activities. This role will support Medicaid program integrity activities related to fraud, waste, and abuse prevention; provider oversight; compliance monitoring; risk assessment; external audit coordination; recovery efforts; and Medicaid medical, dental, behavioral health, and pharmacy claims audits. In this role, the Medicaid Program Integrity Specialist will work closely with Program Integrity staff, TPL experts, forensic specialists, data analysts, compliance SMEs, integrated IT, operations, and policy workstream members, vendor partners, and project leadership to translate Medicaid policy, program needs, claims analytics, and audit findings into practical monitoring approaches, review priorities, system requirements, change requests, operational recommendations, corrective action supports, and process improvement considerations. This individual will support dashboards, reporting, documentation quality, issue escalation, knowledge transfer, quality assurance, and ongoing improvement of payment integrity activities." We can put that as About the role. Responsibilities: The "You Will Support" bullet list (actually sentences). Let's extract each duty: - Support development of recommendations for cost avoidance, recovery, improved program controls, policy clarification, process improvement, system edits, vendor follow-up, and corrective action planning based on claims analytics and program integrity findings. - Research, interpret, and apply Medicaid payment policy, program integrity requirements, audit findings, federal and state requirements, managed care contract expectations, provider billing guidance, and operational procedures to support defensible review conclusions and recommendations. - Document and report claims audit findings, payment integrity observations, risk indicators, analytical results, and recommended actions clearly and consistently for management, client stakeholders, vendors, and project leadership. - Support training, technical assistance, workgroup facilitation, release readiness, go-live support, and knowledge transfer related to payment integrity analytics, review processes, dashboard use, documentation expectations, and follow-up procedures. - Provide quality assurance reviews of work completed by peers, including claims audit documentation, analytical findings, review protocols, reports, corrective action supports, and client-facing deliverables. - Use Jira, SharePoint, meeting notes, decision logs, action item trackers, dashboards, and reporting tools to support transparent issue tracking, documentation, coordination, and follow-through across our workstreams. - Support onsite planning, release activities, operational readiness, and related project needs in coordination with project leadership and workstream leads. - Use the following key tools and systems: Microsoft Excel, and analytics and dashboarding tools for claims analysis, payment integrity monitoring, validation, visualization, and reporting. Jira for action items, risks, blockers, dependencies, audit follow-up, corrective action tracking, dashboard visibility, release readiness, and project coordination. SharePoint for project documentation, report templates, payment integrity methodology, review protocols, version control, quality review, training materials, and knowledge management. Microsoft Teams and Outlook for meeting coordination, stakeholder communication, workgroup facilitation, audit follow-up, training support, and client/vendor collaboration We can combine tool usage maybe under Skills, but responsibilities include using tools. We'll keep responsibilities as above. Requirements: Minimum qualifications: "Strong leadership, communication, facilitation, organization, and attention to detail. Knowledge of Medicaid program integrity, fraud, waste, and abuse prevention, provider oversight, claims review, audit support, compliance monitoring, or related public sector healthcare operations. Knowledge of quality assurance/control procedures, corrective action tracking, and proactive problem management. Demonstrated ability to work effectively in a team setting and coordinate across multiple stakeholders, including clients, vendors, project leadership, and internal teams. Experience coordinating recurring meetings, documenting follow-up items, maintaining workstream alignment, and supporting escalation pathways. Strong experience with Microsoft applications and artificial intelligence tools. Bachelor’s degree preferred; applicable experience may be considered in lieu of degree requirements. Experience using Jira, SharePoint, Microsoft Teams, Outlook, Excel, Power BI, Tableau, SQL, or comparable tools to manage action items, documentation, reporting, follow-up, and project coordination. Minimum three (3) years of experience in a comparable analytics, payment integrity, program integrity, claims audit, Medicaid operations, healthcare compliance, or consulting role preferred." We can put these under Requirements. Qualifications: Preferred qualifications: "Prior consulting experience in a national or regional consulting firm, health plan, Medicaid agency, program integrity unit, or public sector health and human services environment. Experience with government agencies, Medicaid program integrity units, fraud risk assessments, internal audits, external audits, claims audit reviews, quality assurance, corrective action planning, or improper payment prevention efforts. Bachelor's Degree (BA/BS)—may substitute four years of applicable experience for the degree. Preference may be given to candidates with certifications such as Certified Professional Coder, Certified Fraud Examiner, Certified Professional Medical Auditor, Certified Internal Auditor, or equivalent credentials." We can put under Qualifications. Skills: maybe list of tools and competencies: "Microsoft Excel, analytics and dashboarding tools, Jira, SharePoint, Microsoft Teams, Outlook, Power BI, Tableau, SQL, artificial intelligence tools." Also "leadership, communication, facilitation, organization, attention to detail." But those are in Requirements. We could still have Skills section for technical skills. However we must avoid duplication? Not prohibited but better to keep distinct. We'll put technical skills under Skills. Benefits: from BerryDunn Benefits & Culture: "Eligible employees have access to benefits that go beyond what’s expected to support their physical, mental, career, social, and financial well-being. Visit our website for a complete list of benefits and a look into our culture: Experience BerryDunn . We will ensure that individuals are provided reasonable accommodation to participate in the job application or interview process or perform essential job functions. Please contact careers@berrydunn.com to request an accommodation." Also mention equal opportunity but that's boilerplate; we should remove EEO boilerplate. The benefits paragraph is substantive enough. Pay: Compensation Details: base salary range $95,000-$120,000. Also description about factors. We'll include that. Schedule: Work location and travel expectations: "Work location: This position offers flexibility in work location, including fully onsite, hybrid, or remote arrangements. The preferred location is Kapolei, Hawaiʻi, or the U.S. West Coast. Regardless of location, the role requires availability during Hawaii Standard Time (HST) working hours. Travel expectations: This role requires travel approximately 30%–50% of the time, including travel to Hawaiʻi for onsite client meetings, release activities, training support, go-live readiness, payment integrity workgroup sessions, and related project needs." We'll put that under Schedule. Now produce HTML fragment with headings

and content in

or

• . For lists we need to decide which content is list. Responsibilities: each duty can be
• . Requirements: each bullet maybe
• . Qualifications: each bullet
• . Skills: maybe
  • . Benefits: maybe

    . Pay:

    . Schedule:

    (could be two sentences). Ensure we don't repeat job title. Let's craft. We must not include markdown code fences. Just raw HTML. Let's produce:

    About the role

    BerryDunn is seeking a Medicaid Program Integrity Analyst to support Hawaiʻi Med-QUEST's (MQD) Third Party Liability (TPL) Unit and Program Integrity activities. This role will support Medicaid program integrity activities related to fraud, waste, and abuse prevention; provider oversight; compliance monitoring; risk assessment; external audit coordination; recovery efforts; and Medicaid medical, dental, behavioral health, and pharmacy claims audits. In this role, the Medicaid Program Integrity Specialist will work closely with Program Integrity staff, TPL experts, forensic specialists, data analysts, compliance SMEs, integrated IT, operations, and policy workstream members, vendor partners, and project leadership to translate Medicaid policy, program needs, claims analytics, and audit findings into practical monitoring approaches, review priorities, system requirements, change requests, operational recommendations, corrective action supports, and process improvement considerations. This individual will support dashboards, reporting, documentation quality, issue escalation, knowledge transfer, quality assurance, and ongoing improvement of payment integrity activities.

    Responsibilities

    • Support development of recommendations for cost avoidance, recovery, improved program controls, policy clarification, process improvement, system edits, vendor follow-up, and corrective action planning based on claims analytics and program integrity findings.
    • Research, interpret, and apply Medicaid payment policy, program integrity requirements, audit findings, federal and state requirements, managed care contract expectations, provider billing guidance, and operational procedures to support defensible review conclusions and recommendations.
    • Document and report claims audit findings, payment integrity observations, risk indicators, analytical results, and recommended actions clearly and consistently for management, client stakeholders, vendors, and project leadership.
    • Support training, technical assistance, workgroup facilitation, release readiness, go-live support, and knowledge transfer related to payment integrity analytics, review processes, dashboard use, documentation expectations, and follow-up procedures.
    • Provide quality assurance reviews of work completed by peers, including claims audit documentation, analytical findings, review protocols, reports, corrective action supports, and client-facing deliverables.
    • Use Jira, SharePoint, meeting notes, decision logs, action item trackers, dashboards, and reporting tools to support transparent issue tracking, documentation, coordination, and follow-through across our workstreams.
    • Support onsite planning, release activities, operational readiness, and related project needs in coordination with project leadership and workstream leads.
    • Use the following key tools and systems: Microsoft Excel, and analytics and dashboarding tools for claims analysis, payment integrity monitoring, validation, visualization, and reporting; Jira for action items, risks, blockers, dependencies, audit follow-up, corrective action tracking, dashboard visibility, release readiness, and project coordination; SharePoint for project documentation, report templates, payment integrity methodology, review protocols, version control, quality review, training materials, and knowledge management; Microsoft Teams and Outlook for meeting coordination, stakeholder communication, workgroup facilitation, audit follow-up, training support, and client/vendor collaboration.

    Requirements

    • Strong leadership, communication, facilitation, organization, and attention to detail.
    • Knowledge of Medicaid program integrity, fraud, waste, and abuse prevention, provider oversight, claims review, audit support, compliance monitoring, or related public sector healthcare operations.
    • Knowledge of quality assurance/control procedures, corrective action tracking, and proactive problem management.
    • Demonstrated ability to work effectively in a team setting and coordinate across multiple stakeholders, including clients, vendors, project leadership, and