Job Description

Overview:

J29, Inc. (J29) has been supporting commercial, State, and Federal health and human service programs since company inception in 2017 as a healthcare management consulting company. Our team of 260 employees focuses on providing processing, review, and analysis of medical claims, records, data, and audits between areas of compliance, policy, and clinical expertise. Our team is experienced in program, payment, provider, and patient integrity as we continue to support advanced programs of policy, clinical requirements, and compliance measures at the commercial, State, and Federal levels. 

J29 was founded to be an employee-centric company that prioritizes the well-being and value of its employees. Our mission is to empower our employees to do great things for the benefit of those that need it most. The J29 mission supports not only our health and human service programs, but also the philanthropy efforts of our team. We are proud to continue our support to non-profit groups with critical missions as J29 continues to grow.  

Position Purpose: 

J29 is looking for a Healthcare Review / Audit Consultant to support our work on a Centers for Medicare and Medicaid Services (CMS) project with the Office of Financial Management (OFM).   

This role will help us ensure that we successfully conduct thorough reviews of CMS programs, specific to the Affordable Care Act. The Consultant will work with a team of reviewers to support a CMS program integrity initiative that reviews a random sample of health insurance applications off of the Federally-Facilitated Exchange (FFE). The individual will be expected to analyze data and process documentation; identify policy and program updates; update program materials; verify error findings with stakeholders; document lessons learned; and contribute to development of program documents and reporting. To succeed in this role, the individual should have some experience in conducting data validation and/or audits, excellent time management skills, and communication skills as he/she collaborates with the team and external stakeholders.   

In addition, the individual will be responsible for supporting other firm-wide initiatives to support the growth of the firm.   

• 3 years of professional experience in audit, compliance, research, program management, process improvement, or operations  

• Familiarity and experience with the healthcare ecosystem, particularly Medicare 

• 3+ years of experience with and/or knowledge of data analysis in the healthcare field 

• Comfort and ability to present to internal and external stakeholders, and proven ability to be a strong writer.  

• 3+ years of healthcare review or auditing experience in an independent and remote workplace. 

• Ability to work independently as well as part of a team, with experience identifying and communicating key work issues to project and task leaders 

• Acute attention to detail, process-oriented, and strong work ethic  

• Cultural alignment to J29’s core values, focused around effective communication, respect, team work, and unity. 

• Demonstrates thoroughness, creativity, foresight, and use of sound business judgment in the application of healthcare auditing or review principles, corporate policies, and business practices. 

• Must have self-motivation, initiative, and critical thinking. 

 
What Would Be Nice To Have: 

• Strong and proven knowledge of Health Insurance Exchanges preferred, but not required  

• Strong and proven knowledge of Medicare, Medicaid, Medicare Advantage preferred, but not required 

• Auditing experience preferred, in a healthcare ecosystem 

Education / Certifications: 

• Bachelor’s degree in health policy, public health, public policy, or other health, finance, accounting, or social science related field  

 J29, Inc. is committed to hiring and retaining a diverse workforce. We are proud to be an Equal Opportunity/Affirmative Action Employer, making decisions without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, veteran status, disability, or any other protected class.  J29, Inc. is a proud Veteran friendly employer. 

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