• The lead reviewer is accountable for the validation of existing Fraud, Waste and Abuse business rules/leads designed to detect aberrant billing patterns as reviewing incoming referrals • Research and ad hoc report development to identify fraud, waste and abuse schemes and trends • Review company clinical & payment policies to determine the impact of the scheme on Aetna business • Identify all possible issues related to fraud, waste and abuse when reviewing a new lead or referral • Keep current with new & emerging fraud, waste and abuse schemes and trends through training sessions and industry resources • Interpret, analyze and present key findings to internal customers (project team, investigators) providing recommendations based on analytical findings

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways. At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today! This job, under moderate supervision, provides analysis to the particular area of the business they support. Analyzes and reports on monthly financial statements and maintains databases and other sources of information. Supports strategic projects leveraging financial and analytic capabilities. Assists in the budget process. Responds to Ad Hoc Reporting requests and answers questions from users of the financial reports.To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties. This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion. Education Required - Bachelor's degree in Accounting, Finance, Math, Business Administration, or Computer Science or related area Preferred - Master’s degree in Business Administration (MBA) or other advanced degree in Accounting, Finance, or related field Work Experience Preferred - Experience in financial analysis, forecasting and reporting Preferred- Experience in the healthcare industry Knowledge Skills and Abilities (KSAs) - Must have computer skills and dexterity required for data entry and retrieval of information. Must be proficient with Windows-style applications, various office software packages and keyboard. - Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process. - Strong analytical and problem solving skills - Excellent organizational and time management skills - Good judgment and decision-making skills Job Duties - Updates and maintains financial information. - Provides reporting and analytics to ensure operational profitability. - Identifies opportunities for revenue enhancement. - Participates in formation of budget. - Participates in quality assurance activities. - Participates in activities for professional development. - Participates in special projects involving financial analysis. Other related duties as required. The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time. Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards. This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns. The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status. Physical and Environmental Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects. (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible. NOTE: The constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible. Mechanical lifting devices (carts, dollies, etc.) or team lifts should be utilized. Must be able to stoop, bend, reach and grab with arms and hands, manual dexterity. Must be able to sit for prolonged periods of time. Must be able to travel throughout and between facilities. Must be able to work a flexible work schedule (e.g., more than eight hours a day). Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid. There is no occupational risk for exposure to communicable diseases. Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role. Are you ready to make a difference? Apply Today! Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website. Please refer to the job description to determine whether the position you are interested in is remote or on-site. Individuals who reside in and will work from the following areas are not eligible for remote work position: Colorado, California, Hawaii, Illinois, Maryland, Massachusetts, Minnesota, New Jersey, New York, Vermont, Washington, and Washington D.C. Ochsner Health endeavors to make our site accessible to all users. If you would like to contact us regarding the accessibility of our website, or if you need an accommodation to complete the application process, please contact our HR Employee Solution Center at 504-842-4748 (select option 1) or careers@ochsner.org. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. Ochsner is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to any legally protected class, including protected veterans and individuals with disabilities.

• Responsible for the technical EPIC HB contract build and modeling functions including the Hyperdrive, Text, and Data Courier environments. • Responsible for design, development and testing of reports using innovative techniques, analyzing data from various sources and systems. • Prepare accurate data analysis in order to communicate with regulatory agencies, contracted payers and internal leadership. • Build and maintain advanced Microsoft Excel contract models in order to meet the functional needs of staff and streamline process flow. • Recommend and implement technical solutions to assist in planning, streamlining and decision making. • Maximize reimbursement by analyzing contract variances, new technology, denial trending, payment variance trending and regulatory changes. • Use of performance improvement, project management and technology skills.

Are you looking for an opportunity to truly make a difference? Do you want to join a collaborative, mission-driven team that protects the planet, strengthens communities, and supports businesses when they need it most? Are you seeking a place where your work contributes directly to an organization known for excellence in environmental services, crisis management, and emergency response? If your answer is “yes,” then you belong at Ambipar. FEMA Benefit Cost Analyst – WOB Position Summary Witt O'Brien's is seeking an innovative, motivated, and talented Benefit Cost Analyst to join our team. The ideal candidate will be responsible for performing detailed benefit cost analyses (BCA) for FEMA HMGP and other FEMA HMA programs, as well as FEMA 406 Mitigation. This position focuses on completing engineering feasibility reviews, completing BCAs, and developing BCA methodologies for positive outcomes. The Benefit Cost Analyst may travel to disaster-impacted areas to support Witt O'Brien's clients in delivering trans- and post-recovery assistance. Position Details - Reports to: Associate Managing Director - Location: Remote - Position Type: Regular Full Time - FLSA Status: Exempt - Pay: Salary - Compensation: Commensurate with experience - Travel: As needed (mostly remote) Essential Job Functions - Provides technical guidance on the FEMA BCA Toolkit - Develops detailed BCAs within the FEMA BCA toolkit for HMA sub-applications and amendments using a FEMA approved methodology and supporting documentation. - Collects and analyzes data related to hazard risk, historical damages, etc. to support the BCA. - Ensures mitigation project applications comply with FEMAs BCA requirements - Evaluates the applicability of pre-determined / pre-calculated benefits when applicable. - Evaluates and reviews designs and technical studies related to drainage or civil projects. - Conducts site inspections to assess hazard vulnerabilities and validate the feasibility of proposed mitigation measures - Advises applicants on incorporating mitigation into recovery and mitigation projects, including floodproofing, wind retrofits, utility hardening, slope stabilization, and stormwater upgrades - Manages assigned projects using company-standard project management principles. - Performs other duties as assigned Minimum Job Requirements - 5+ years of experience in benefit costs analysis development and proficiency with FEMA BCA tools. - Working knowledge of civil engineering principles - Experience developing and reviewing engineering-based mitigation measures in recovery projects, including designs, technical documents, Hydrologic & Hydraulic Studies, etc. - Communicate technical issues to a wide range of stakeholders - Demonstrated experience and knowledge of FEMA HMA Program Policy and FEMA 406 Mitigation Policy at the FEMA, state, local, or consulting level - Strong written and oral communication skills for technical and client-facing deliverables - Ability to manage multiple projects in a dynamic, post-disaster work environment - Proficiency in MS Teams, Word, Excel, PowerPoint, and Adobe Acrobat Preferred Job Requirements - Bachelor's degree from an accredited college or university with a major in engineering, public administration, emergency management, business administration, or related field - GIS and HAZUS-MH or risk modeling software skills for hazard assessment and documentation - Experience coordinating with FEMA EHP and engineering staff on compliance issues - Certifications such as a Certified Floodplain Manager (CFM) or relevant project management certifications Job Description Disclaimer This position description incorporates the core responsibilities of the job. It recognizes that other related duties not specifically mentioned might also be performed, and that not all responsibilities may be carried out depending on operational needs. Commitment to Diversity - Witt O'Brien's is always looking for the most qualified and experienced professionals with a passion for public safety, emergency management, homeland security, disaster response, and continuity of operations. - We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. Equal Opportunity Employer/Veteran/Disabled With you when it counts.