Palm Beach Accountable Care Organization · 2 months ago
Healthcare Project Manager
Palm Springs, FL
Full-time
Onsite
Mid Level
$50K/yr - $65K/yr
3+ years expPalm Beach Accountable Care Organization (PBACO) is one of the nation’s top-performing ACOs, committed to improving patient care and reducing costs. They are seeking a detail-oriented Project Manager to lead fraud prevention initiatives, analyze claims data, and collaborate with enforcement agencies to protect patients and maintain financial health.
Health CareInformation Technology
Responsibilities
Review Medicare and commercial claims data to detect potential fraud (DME, wound care, genetic testing, etc.)
Report suspected fraud to OIG and Safeguard Services in compliance with federal guidelines
Manage provider attestations, ensuring timely responses and escalations when needed
Partner with internal teams to develop fraud detection dashboards and workflows using SQL and BlueSky Analytics
Prepare and submit monthly/quarterly fraud cases and enforcement packages
Stay ahead of emerging fraud schemes through continuous monitoring, research, and process improvement
Provide regular updates to leadership and support cross-functional initiatives that strengthen compliance and efficiency
Qualification
Required
Bachelor's degree in Healthcare Administration, Compliance, Data Analytics, or related field
3+ years of experience in healthcare compliance, fraud prevention, or project management
Familiarity with Medicare regulations, CMS fraud guidance, and enforcement agencies (OIG, UPIC)
Strong data analysis skills, with experience in SQL, reporting tools, and MS Office
Exceptional attention to detail, organization, and documentation accuracy
Excellent communication and stakeholder engagement skills with providers and healthcare partners
Preferred
Experience in an ACO, payer, or healthcare compliance environment
Knowledge of CPT/HCPCS coding, DME claims processes, and fraud detection tools
Background with EMRs/HIM systems or population health strategies
Benefits
Competitive compensation
Comprehensive benefits package
Company
Palm Beach Accountable Care Organization
Palm Beach Accountable Care Organization physicians have identified prevention as a key factor in improving overall patient health.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Amanda Larschan, MHA, PMP
Chief Data Officer
Company data provided by crunchbase