Business Analyst: Fraud, Waste & Abuse (Denver Health Medical Plan)
Location: Denver, Colorado
Type: Full Time
Salary: $42,000.00 - $56,700.00
Internal Number: 7246
Under minimal supervision supports the continuous evaluation of the Department in alignment with Denver Health's financial, strategic, and operational initiatives and projects. Evaluates business processes, anticipates opportunities and challenges, indentifies areas for improvement and makes data driven recommendations. Coordinates and performs duties related to data acquisition and analysis for multiple projects simultaneously.
This position is responsible for the prospective and retrospective investigation of suspect claims and the development of fraud, waste, abuse and overpayment recovery cases. This includes independently gathering, analyzing and interpreting complex data and information to provide meaningful results in developing leads, collaboration with internal resources as well as complying with state and federal requirements for fraud, waste and abuse detection and prevention. Additionally this role assists in the training of new associates and in education to business areas to be on the alert for suspect claims or potentially fraudulent activity.
Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver’s 911 emergency medical response system, 10 family health centers, 18 school-based health centers, Rocky Mountain Poison and Safety, a Public Health department, an HMO and The Denver Health Foundation.
As Colorado’s primary, and essential, safety-net institution, Denver Health is a mission-driven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community, focusing on hiring and purchasing locally as applicable, serving as a pillar for community needs, and caring for more than 185,000 individuals and 67,000 children a year.
Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.
We strongly support diversity in the workforce and Denver Health is an equal opportunity employer (EOE).
Denver Health is committed to provide equal treatment and equal employment opportunities to all applicants and employees. As an EOE, De...nver Health does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.