Overview

<b>Job Number: R0055203</b><br /><br />Healthcare Program Integrity Data Analyst<br />Key Role:<br /><br />Collaborate with a team focused on supporting federal healthcare clients on program integrity initiatives. Conduct quantitative analysis on specific requirements and policies related to program integrity and Federal-wide Assurance (FWA). Review and analyze claims data, implement business rules, and develop models to detect and combat fraud, waste, and abuse in Medicare and Medicaid. Conduct quantitative and qualitative analysis. Coordinate the efforts of multi-disciplinary teams consisting of software and data engineers, data scientists, medical or clinical professionals, and policy experts. Provide client-ready project documentation to supervisors and management, including summary analysis and next-step recommendations. Lead defined project work streams and apply knowledge of commonly used healthcare concepts, practices, and procedures.<br /><br />Basic Qualifications:<br /><br />-8+ years of experience with Health and Human Services (HHS) program integrity, identifying, investigating, reporting, and resolving instances of healthcare fraud, waste, and abuse, and CMS infrastructure, data, data systems, and data structure<br /><br />-6+ years of experience with data analysis and statistics<br /><br />-4+ years of experience with task, project, and team management<br /><br />-Experience with SAS, R, Python, or equivalent tool<br /><br />-Ability to analyze a variety of sources to uncover issues and form recommendations<br /><br />-Ability to function independently, collaborate in a team environment, and manage teams<br /><br />-Ability to obtain a security clearance<br /><br />-BA or BS degree in Statistics, CS, Mathematics, or Engineering<br /><br />Additional Qualifications:<br /><br />-6+ years of experience with algorithm design and analysis preferred<br /><br />-Experience with general management consulting<br /><br />-Possession of excellent oral and written communication skills<br /><br />-CFE, AHFI, or CHC Certifications preferred<br /><br />Clearance:<br /><br />Applicants selected will be subject to a security investigation and may need to meet eligibility requirements for access to classified information.<br /><br />We're an EOE that empowers our people-no matter their race, color, religion, sex, gender identity, sexual orientation, national origin, disability, veteran status, or other protected characteristic-to fearlessly drive change.


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