... Medicaid programs. This role is ideal for someone with deep eligibility experience who enjoys problem-solving, coaching others, and ensuring program integrity. Please: only apply if you have SNAP and ...
... Medicaid programs. This role is ideal for someone with deep eligibility experience who enjoys problem-solving, coaching others, and ensuring program integrity. Please: only apply if you have SNAP and ...
... Medicaid programs. This role is ideal for someone with deep eligibility experience who enjoys problem-solving, coaching others, and ensuring program integrity. Please: only apply if you have SNAP and ...
... Medicaid programs. This role is ideal for someone with deep eligibility experience who enjoys problem-solving, coaching others, and ensuring program integrity. Please: only apply if you have SNAP and ...
... program integrity efforts, including the prevention and detection of fraud, waste and abuse in ... The Medicaid Audit and Compliance Specialist will perform audits as assigned which consist of but ...
... program integrity efforts, including the prevention and detection of fraud, waste and abuse in ... The Medicaid Audit and Compliance Specialist will perform audits as assigned which consist of but ...
... program integrity efforts, including the prevention and detection of fraud, waste and abuse in ... The Medicaid Audit and Compliance Specialist will perform audits as assigned which consist of but ...
... program integrity efforts, including the prevention and detection of fraud, waste and abuse in ... The Medicaid Audit and Compliance Specialist will perform audits as assigned which consist of but ...
Quality Control Reviewer Roanoke-Piedmont Region, Compliance Division W0233 (Repost)
Roanoke, VA · On-site
$55K - $65K/yr
... integrity and non-bias. The QCR identifies procedural misunderstandings by LDSS, describes ... Additional Considerations • Good working knowledge of SNAP/Medicaid eligibility programs; Quality ...
Quality Control Reviewer Roanoke-Piedmont Region, Compliance Division W0233 (Repost)
Roanoke, VA · On-site
$55K - $65K/yr
... integrity and non-bias. The QCR identifies procedural misunderstandings by LDSS, describes ... Additional Considerations • Good working knowledge of SNAP/Medicaid eligibility programs; Quality ...
... integrity and non-bias. The QCR identifies procedural misunderstandings by LDSS, describes ... Good working knowledge of eligibility requirements for the SNAP and Medicaid programs. Ability to ...
... integrity and non-bias. The QCR identifies procedural misunderstandings by LDSS, describes ... Good working knowledge of eligibility requirements for the SNAP and Medicaid programs. Ability to ...
... program integrity efforts, including the prevention and detection of fraud, waste and abuse in ... Medicaid managed care and related oversight activities. The selected leader brings deep experience ...
... program integrity efforts, including the prevention and detection of fraud, waste and abuse in ... Medicaid managed care and related oversight activities. The selected leader brings deep experience ...
... program integrity efforts, including the prevention and detection of fraud, waste and abuse in ... Medicaid managed care and related oversight activities. The selected leader brings deep experience ...
... program integrity efforts, including the prevention and detection of fraud, waste and abuse in ... Medicaid managed care and related oversight activities. The selected leader brings deep experience ...
At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like ... Participates in ongoing, comprehensive training programs as required. * Follows policies and ...
At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like ... Participates in ongoing, comprehensive training programs as required. * Follows policies and ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
Participates in ongoing, comprehensive training programs as required. * Follows policies and ... integrity, collections, payment compliance, credentialing, health information management, customer ...
... Medicaid, CMMI, Center for Program Integrity, etc. Familiarity with contract vehicles such as GSA MAS, OASIS Plus, Stars III. Strong understanding of federal acquisition processes and procurement ...
... Medicaid, CMMI, Center for Program Integrity, etc. Familiarity with contract vehicles such as GSA MAS, OASIS Plus, Stars III. Strong understanding of federal acquisition processes and procurement ...
... Medicaid, CMMI, Center for Program Integrity, etc. · Familiarity with contract vehicles such as GSA MAS, OASIS Plus, Stars III. · Strong understanding of federal acquisition processes and ...
Quick apply
... Medicaid, CMMI, Center for Program Integrity, etc. · Familiarity with contract vehicles such as GSA MAS, OASIS Plus, Stars III. · Strong understanding of federal acquisition processes and ...
... Medicaid, CMMI, Center for Program Integrity, etc. • Familiarity with contract vehicles such as GSA MAS, OASIS Plus, Stars III. • Strong understanding of federal acquisition processes and ...
... Medicaid, CMMI, Center for Program Integrity, etc. • Familiarity with contract vehicles such as GSA MAS, OASIS Plus, Stars III. • Strong understanding of federal acquisition processes and ...
... Care's programs and services for Medicaid beneficiaries, advocates, and community leaders ... and Integrity. Join a team that has a mission to improve health every day and a vision to be the ...
... Care's programs and services for Medicaid beneficiaries, advocates, and community leaders ... and Integrity. Join a team that has a mission to improve health every day and a vision to be the ...
Market Development and Outreach Specialist
Danville, VA · Remote
$10K/mo
... Care's programs and services for Medicaid beneficiaries, advocates, and community leaders ... and Integrity. Join a team that has a mission to improve health every day and a vision to be the ...
Market Development and Outreach Specialist
Danville, VA · Remote
$10K/mo
... Care's programs and services for Medicaid beneficiaries, advocates, and community leaders ... and Integrity. Join a team that has a mission to improve health every day and a vision to be the ...
Market Development and Outreach Specialist
Bristol, VA · Remote
$10K/mo
... Care's programs and services for Medicaid beneficiaries, advocates, and community leaders ... and Integrity. Join a team that has a mission to improve health every day and a vision to be the ...
Market Development and Outreach Specialist
Bristol, VA · Remote
$10K/mo
... Care's programs and services for Medicaid beneficiaries, advocates, and community leaders ... and Integrity. Join a team that has a mission to improve health every day and a vision to be the ...
... Care's programs and services for Medicaid beneficiaries, advocates, and community leaders ... and Integrity. Join a team that has a mission to improve health every day and a vision to be the ...
... Care's programs and services for Medicaid beneficiaries, advocates, and community leaders ... and Integrity. Join a team that has a mission to improve health every day and a vision to be the ...
Medicaid Program Integrity information
What is the difference between Medicaid Program Integrity vs Medicaid Claims Examiner?
| Aspect | Medicaid Program Integrity | Medicaid Claims Examiner |
|---|---|---|
| Primary Focus | Detecting and preventing fraud, waste, and abuse in Medicaid programs | Reviewing and processing Medicaid claims for accuracy and compliance |
| Required Credentials | Typically healthcare or compliance certifications, knowledge of Medicaid policies | Healthcare or claims processing certifications, attention to detail |
| Work Environment | Regulatory agencies, government offices, compliance departments | Insurance companies, healthcare providers, government Medicaid offices |
Medicaid Program Integrity professionals focus on safeguarding Medicaid funds by identifying fraudulent activities, while Medicaid Claims Examiners primarily verify claims for accuracy and proper coding. Both roles require healthcare knowledge and certifications but differ in their core responsibilities and work settings.
What are popular job titles related to Medicaid Program Integrity jobs in Virginia? For Medicaid Program Integrity jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Medicaid Program Integrity jobs in Virginia look for? The top searched job categories for Medicaid Program Integrity jobs in Virginia are:
What cities in Virginia are hiring for Medicaid Program Integrity jobs? Cities in Virginia with the most Medicaid Program Integrity job openings:
Benefits Program Specialist III - CQI Records Reviewer
Abacus Solution GroupVirginia Beach, VA • On-site
Full-time
Posted 15 days ago
Job description
Benefit Program Specialist III
Location: Virginia Beach
About the Role
We are seeking a highly skilled and detail-oriented Benefit Program Specialist III to support quality assurance, compliance, and program improvement efforts across TANF, SNAP, and/or Medicaid programs. This role is ideal for someone with deep eligibility experience who enjoys problem-solving, coaching others, and ensuring program integrity.
Please: only apply if you have SNAP and state system knowledge.
Key Responsibilities
Quality Assurance & Case Review
• Conduct on-site case reviews for Benefit Programs staff to measure, evaluate, and ensure quality performance and compliance with state and federal regulations.
• Review cases for accuracy, identify significant errors or trends, and determine whether issues stem from the section, unit, or individual staff.
• Document findings and compare results with established program guidelines.
• Conduct entrance and exit conferences for scheduled case reviews.
Training, Support & Technical Assistance
• Provide consultation and technical assistance on program policies, regulations, and procedures.
• Deliver refresher training based on case review findings.
• Assist with planning and administering policy tests related to Benefit Program areas.
• Support recruitment and selection of new Benefit Program Specialist team members.
Program Evaluation & Audit Support
• Serve as a team member for SNAP Management Evaluation (ME) Reviews, Regional Reviews, and Audits.
• Conduct research and investigate problematic areas to prepare for state and regional reviews.
• Collaborate with external partners to address error-prone program areas and support corrective action plans.
Policy & System Expertise
• Serve as a resource on eligibility requirements, policy interpretation, and VaCMS troubleshooting.
• Resolve discrepancies internally before escalating to regional or state-level staff.
• Monitor program operations and staff performance to ensure quality standards are met.
• Act as a lead worker, providing guidance and support to team members.
Minimum Qualifications
• A combination of education beyond high school and/or experience equivalent to seven (7) years in roles requiring knowledge of eligibility programs (e.g., Eligibility Worker).
• Equivalent combinations of training and experience that demonstrate the required knowledge, skills, and abilities will be considered.
Preferred Skills
• Strong understanding of TANF, SNAP, and Medicaid eligibility policies.
• Experience conducting case reviews or audits.
Abacus Corporation is a family-owned leader in workforce and talent solutions with over 80 years of experience. We specialize in connecting skilled professionals with direct hire opportunities across industries like industrial, security, healthcare, finance and professional services.
Known for our supportive culture and long-standing client partnerships, Abacus offers more than just a job—we provide a path to lasting career growth with trusted employers nationwide.
• Excellent analytical, communication, and problem-solving abilities.
• Ability to work collaboratively across teams and with external partners.
• Proficiency with VaCMS or similar eligibility systems