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Medicaid Program Integrity Jobs in Virginia (NOW HIRING)

Sky Solutions

Program Director (CMS)

Tysons Corner, VA · On-site

Program Integrity / Fraud Analytics * Medicaid / MMIS / Data Platforms * Marketplace / Eligibility Systems * HCQIS or related CMS portfolios * Experience managing $100M+ federal contracts and ...

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Medicaid Program Integrity information

What is the difference between Medicaid Program Integrity vs Medicaid Claims Examiner?

AspectMedicaid Program IntegrityMedicaid Claims Examiner
Primary FocusDetecting and preventing fraud, waste, and abuse in Medicaid programsReviewing and processing Medicaid claims for accuracy and compliance
Required CredentialsTypically healthcare or compliance certifications, knowledge of Medicaid policiesHealthcare or claims processing certifications, attention to detail
Work EnvironmentRegulatory agencies, government offices, compliance departmentsInsurance 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.

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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:

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Cities in Virginia with the most Medicaid Program Integrity job openings:

Medicaid Program Integrity jobs near you
Infographic showing various Medicaid Program Integrity job openings in Virginia as of August 2026, with employment types broken down into 93% Full Time, 2% Temporary, and 5% Contract. Highlights an 75% In-person, 5% Hybrid, and 20% Remote job distribution.

Business Objects Medicare/Medicaid Data Coach

Tria Federal

Arlington, VA • On-site

Other

Medical, Life

Re-posted 6 days ago

Key responsibilities

  • Train and coach users on navigating BO reports and Medicare/Medicaid universes.

  • Support investigative, analytical, and enforcement teams with Medicare/Medicaid claims analysis.

  • Troubleshoot report errors, access issues, and data discrepancies.

Job description

Who we are:

Tria Federal delivers digital services and technology solutions that support the health and safety of veterans, service members and civilians. For two decades, federal agencies have relied on Tria companies to advance their critical missions and modernize their systems, so that they can uphold their commitment to the American people. Today, we are pushing the boundaries of possibility through partnerships and investments in artificial intelligence and emerging technologies, developing solutions for the biggest challenges that government will face tomorrow.

We are proud to employ and support military veterans who bring mission-first mindset, technical expertise, and leadership qualities that strengthen our work. Veterans, transitioning service members, and military spouses are strongly encouraged to apply.

The Business Objects Medicare/Medicaid Data Coach provides specialized support, training, and expertise to users analyzing Medicare/Medicaid data in SAP BusinessObjects. This role supports Program Integrity stakeholders including UPICs, MEDICs, CMS analysts, contractors, and Law Enforcement partners involved in healthcare fraud investigations.

Key Responsibilities:

  • Train and coach users on navigating BO reports and Medicare/Medicaid universes.
  • Support investigative, analytical, and enforcement teams with Medicare/Medicaid claims analysis.
  • Troubleshoot report errors, access issues, and data discrepancies.
  • Guide users in applying proper filters, parameters, and best practices for BO performance.
  • Assist with Medicare/Medicaid data interpretation for case development, audits, and/or fraud detection.
  • Promote data governance standards and RBAC compliance.
  • Provide documentation, job aids, and short training modules.

Mandatory Requirements:

  • Experience with SAP BusinessObjects reporting tools.
  • Experience with SAP BusinessObjects Web Intelligence Tools
  • Strong understanding of Medicare/Medicaid claims, program integrity workflows, or fraud analytics.
  • Ability to support diverse user groups including Law Enforcement agencies.
  • Excellent communication and technical troubleshooting skills.
  • Team player with excellent executive function and communication skills.
  • US Citizen or Green Card.

Preferred Requirements:

  • Prior work with UPICs, MEDICs, CPS, OIG, DOJ, or CMS systems (IDR, One PI, FPS).
  • Exposure to SAS, Snowflake, Snowsight, or Databricks.

Why Tria?
What defines the Tria brand is more than just our dedication to excellence in our craft; it's our incredible team of dedicated, talented, and passionate people that make Tria so exceptional. As people powering possible, we are all partners in our team's shared success.


As a company that cares about people, we seek to cultivate a culture in which all can thrive personallyandprofessionally. We offer a top-tier benefits package to invest in your physical, mental, and financial health and wellness so that you can be your best self - at workand in life. At Tria, we are growth-minded, entrepreneurial in spirit, and committed to fostering a culture of inclusion and opportunity for all. Whatever your background, your role, your department, or stage in your professional journey, here you will have opportunities to learn new skills, seize new challenges, and advance your career as we grow.

California Consumer Privacy Act (CCPA)

We are committed to protecting your privacy. As part of our compliance with the California Consumer Privacy Act (CCPA), we want to inform you about how we collect, use, and protect your personal information during the job application process. For more details, please review https://www.oag.ca.gov/privacy/ccpa.

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