Data Analyst II
About The Position
GDIT is hiring a Data Analyst to support our CMS team. The Affordable Care Act (ACA) requires every state to establish a health insurance exchange (also called Health Insurance Marketplace) to facilitate the purchase of health insurance for individuals and small businesses. Through the Center of Program Integrity (CPI), Centers for Medicare & Medicaid Services (CMS) has strong oversight and internal controls to protect consumers enrolled in the Marketplaces and safeguard taxpayer dollars. CMS develops and enforces rules for insurance agents, and brokers, and others who assist with Federally Facilitated Marketplace (FFM) enrollments. The Marketplace Program Integrity Contractor (MPIC) is designed to support this oversight. Through research, investigation and data analysis, the desired outcomes of the MPIC efforts are to prevent, detect, and resolve noncompliance with Marketplace rules, requirements, and laws; recommend administrative actions to CMS; and recommend referrals to law enforcement if potential fraud and abuse is identified. The Data Analyst develops, analyzes and models operational, economic, Marketplace, MPIC, and other organizational data to support customer needs, quantify the performance of business segments, evaluate potential operational changes, and design new approaches and methodologies. Applies and integrates statistical, mathematical, predictive modeling and business analysis skills to manage and manipulate complex, high-volume data from a variety of sources. Reviews and conducts necessary data analysis to respond to requests from other business area, customer, and other agencies’ data requests.
Requirements
- Bachelor’s degree or equivalency in healthcare field that includes 2-4 years’ ACA and/or Medicaid-Medicare experience.
- 2+ years’ experience in data analytics, modeling, and/or risk analysis.
- Experience with and/or understanding of ACA policies and regulations related to consumer enrollments requirements and Agent/Broker and Navigator responsibilities.
- Proficient in computer skills, for example SAS, modeling, Microsoft Office-Word, Excel.
- Frequent work with workgroups to successful completion of goals and milestones.
- Experience developing, reviewing, and quality assurance of complex data reports/sets.
- Highly organized, ability to multi-task, and meet deadlines.
- Requires only limited oversight to conduct work.
- Strong inter-personal and communications skills, both written and oral.
- Ability to conceptualize, solve problems, and draw conclusions.
- Must be able to pass a CMS background check.
Nice To Haves
- Experience with FWA claims and related data collection, analysis, interpretation responsibilities.
- Experience with case tracking system data entry, resolution of data issues, and other related troubleshooting.
Responsibilities
- Performs data analysis, and interpretation.
- Develops rules and methodologies for data collection and analysis.
- Work collaboratively within a team of data analysts and other MPIC staff to obtain data and analysis to support program work.
- Strictly follow approved Standard Operating Procedures (SOPs) for conducting work and provide input into recommendations for SOP updates as needed.
- Analyze and evaluate enrollment data related to consumer and Agent/Broker activity within the Marketplace.
- Assist in the process to prioritize, evaluate, and analyze information to identify abnormal behavior using data related to consumer enrollments into qualified health plans and/or data related agents/brokers’ activities.
- Within MPIC management and tracking systems, comprehensively document in detail work associated with data collection, analysis, interpretation.
- As needed, assist in ad-hoc educational and outreach sessions with partners, e.g., CMS, law enforcement, Agent/Brokers, Navigators, etc.
- Safeguard PII and PHI
Benefits
- 401K with company match
- Comprehensive health and wellness packages
- Internal mobility team dedicated to helping you own your career
- Professional growth opportunities including paid education and certifications
- Cutting-edge technology you can learn from
- Rest and recharge with paid vacation and holiday
- variety of medical plan options, some with Health Savings Accounts
- dental plan options
- a vision plan
- a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match.
- full flex work weeks where possible
- a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave.
- short and long-term disability benefits
- life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
