Senior Data Analyst

This is a fully remote position, open to applicants in Virginia.

📋 Description

• Develop and implement models and analytical strategies to support the detection of fraud, waste, and abuse in Medicare and Medicaid.

• Utilize expertise in healthcare data and policy to hypothesize potential fraud schemes reflected in the data.

• Design and execute tests to validate these hypotheses and create fraud detection models.

• Identify anomalies and investigate possible indicators of fraudulent behavior.

• Recognize outliers and patterns that align with fraud, waste, or abuse activities.

• Build advanced models for focused analyses using programming languages such as Python, R, SQL, and SAS.

• Extract and manipulate Medicare, Medicaid, and other healthcare claims data within cloud environments.

• Plan and execute targeted analyses and develop related documentation.

• Stay informed about Medicare and Medicaid policies and adjust methodologies in response to policy modifications.

• Engage in testing sprints and other project-related initiatives.

• Offer subject matter expertise and guidance to Statistical and Data Analysts.

• Assist in task execution while ensuring quality through peer reviews and technical support.

• Create comprehensive analytical reports.

• May act as Team Lead by organizing, coordinating, and documenting project activities, managing team performance, and communicating with clients.

⛳️ Requirements

• A minimum of a 4-year degree in statistics, mathematics, computer science, or a related field, OR at least 6 years of data analysis experience in the healthcare sector.

• At least 6 years of professional experience handling large and complex data sets.

• Advanced understanding of analytic, mathematical, and statistical methodologies.

• Experience with healthcare claims data, particularly pertaining to Medicare and Medicaid.

• Familiarity with ICD10 codes, HCPCS, and Diagnosis Related Groups (DRG).

• Proficient in merging diverse datasets and performing INNER/LEFT/RIGHT joins, using functions such as COALESCE(), CAST(), SUBSTR(), LAG(), and PROC SQL.

• Relevant background in a health-related, scientific, or public policy/business field with strong quantitative/statistical expertise.

• Proficient in SAS, Python, R, and/or SQL.

• Skilled in Microsoft Office applications, including Excel, Word, PowerPoint, and Outlook.

• Knowledgeable about analytic methodologies and principles.

• Familiar with program integrity data analytics.

• Capable of responding to tasks or requests in a timely and collaborative manner.

• Demonstrated ability to adapt to changing circumstances.

• Strong skills in customer service, organization, and analysis.

• Proficient in performing complex mathematical calculations.

• Excellent leadership and presentation skills.

• Ability to work autonomously as well as collaboratively within a team.

• Capable of multitasking and prioritizing tasks to meet deadlines.

• Must successfully pass post-hire background screening checks.

• Ability to obtain security clearance if required by the Client/Contract.

• For remote work, must have wired and/or wireless internet access.

🏝️ Benefits

• Vacation

• Sick leave

• Paid holidays

• Health insurance

• Dental insurance

• Vision insurance

• Short- and long-term disability

• Life insurance

• Employee assistance plan

• 401(K) retirement plan

• Educational benefits

• Remote work

• Wired and/or wireless internet access required for remote work