Sr. Program Integrity Analyst
Job description
About the role
HHAeXchange serves as the premier technology platform dedicated to home and community based care. Established in 2008, the company was created to deliver a comprehensive end to end homecare solution for aging individuals and those with disabilities, driven by a strong mission to transform the healthcare landscape by connecting patients, personal care providers, managed care organizations, and states. The Senior Program Integrity Analyst plays a vital role within the expanding Program Integrity team, focusing on safeguarding public funds and ensuring program integrity across the platform. This position requires a deep understanding of both investigative analysis and product development to bridge the gap between raw data and actionable insights for customers.
Key facts
What you'll do
Identify complex patterns of fraud, waste, and abuse within the large Medicaid home and community based care datasets.
Translate those detailed analytical findings into scalable detection capabilities that are embedded directly within the HHAeXchange platform.
Serve as the primary domain expert bridging investigative analysis, product development, and customer engagement functions across the company.
Ground all product development activities in operational and regulatory reality to ensure practical and compliant application.
Ensure that every detection logic remains clinically sound, investigatively credible, and directly actionable by the end customers.
Guarantee that all analytical outputs are directly actionable by customers who rely on them to protect public funds.
Collaborate closely with product teams to align detection features with the specific needs of HHAeXchange customers.
Partner with engineering teams to build, refine, and maintain scalable detection mechanisms that operate effectively within the system.
Engage with client facing teams to ensure that analytical findings consistently create measurable value for HHAeXchange customers.
Perform each essential job duty satisfactorily with or without reasonable accommodation to support the growing Program Integrity function.
Requirements
Demonstrate substantial expertise in identifying fraud, waste, and abuse patterns within complex healthcare data environments.
Possess a deep understanding of Medicaid home and community based care regulatory frameworks and compliance standards.
Have the proven ability to translate complex analytical findings into scalable and effective product detection capabilities.
Show proficiency in bridging the gap between investigative analysis methodologies and modern product development processes.
Maintain a strong foundation in ensuring that analytical methodologies remain both clinically sound and investigatively credible.
Exhibit the capacity to perform essential job duties with or without reasonable accommodation in a remote setting.
Bring prior experience working directly with client facing teams to consistently deliver actionable and measurable customer value.
Display a strong commitment to grounding all product decisions in operational and regulatory realities rather than assumptions.
Nice to have
Familiarity with homecare ecosystems that fully connect patients, personal care providers, managed care organizations, and state agencies.
Experience working within state level healthcare program integrity operations to actively protect public funds from misuse.
Background in building end to end solutions specifically designed to help aging and disabled populations thrive.
Knowledge of creating fully comprehensive care platforms that support individuals aging or having disabilities in their own homes.
Familiarity with state Medicaid programs and the specific nuances of home and community based care delivery.
Skills & tools
Proficiency in analyzing large scale Medicaid home and community based care datasets efficiently.
Capability to design and implement scalable fraud, waste, and abuse detection logic within software platforms.
Skill in translating operational and regulatory requirements into clear and actionable technical product specifications.
Aptitude for collaborating across product, engineering, and client facing organizational teams to achieve shared goals.
Understanding of how to embed detection capabilities directly into existing software platforms without disrupting workflows.
Competence in ensuring that all analytical findings remain clinically sound, investigatively credible, and fully compliant with industry standards for stakeholders.
Practical notes
This position is a remote opportunity available to candidates located within the EST or CST time zones.
The listed location for this role is the United States, meaning no office relocation is necessary.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions.
The role is a full time engagement within the growing Program Integrity function at HHAeXchange.
Candidates must be able to perform each essential job duty satisfactorily with or without reasonable accommodation as needed.
About the company
HHAeXchange is the leading technology platform for home and community-based care. Founded in 2008, HHAeXchange was born out of an idea to create a fully comprehensive end-to-end homecare solution to help people who are aging or have disabilities thrive in their homes and communities.