Fraud Business Analyst SME

Node.Digital

8h•Remote

About The Position

Fraud Business Analyst SME Remote work Preferred: US Citizenship • Ability to obtain and maintain an HHS Background Investigation (Public Trust) suitability determination. Key Responsibilities Requirements Elicitation and Traceability • Facilitate structured requirements workshops with HRSA program stakeholders (OIG, Grants Division, FDMP program office) to elicit and document business requirements for fraud detection, anomaly flagging, and case management workflows. • Translate business requirements into user stories, acceptance criteria, and process flows; maintain a traceable requirements matrix (RTM) throughout the EPLC lifecycle. • Review and validate EPLC planning deliverables (Business Requirements Documents, Concept of Operations, System Requirements Specifications) to ensure they accurately reflect HRSA’s fraud detection intent. Fraud Domain SME Support • Apply working knowledge of federal grant fraud, waste, and abuse (FWA) patterns to inform model design decisions: improper payment types, duplicate entity schemes, inflated cost reports, and sub-awardee integrity risks across HRSA grant programs. • Support the AI/ML Lead Engineer in defining supervised classification labels, anomaly detection thresholds, and SHAP feature interpretation from a business-rules perspective. • Validate model outputs and HITL review queues against known FWA patterns; flag false-positive risks and provide business-logic guardrails to data science team. • Contribute to the design of the Portfolio Risk Manager agent’s risk scoring logic and grantee-level threshold calibration; ensure scoring outputs are interpretable and defensible for HRSA investigators. Agile Delivery and Sprint Governance • Own and maintain the product backlog in coordination with the Program Manager and AI/ML Lead Engineer; write well-formed user stories and acceptance criteria for all sprint deliverables. • Facilitate Agile ceremonies including sprint planning, backlog refinement, sprint review, and retrospective in accordance with the program’s SAFe-aligned delivery cadence. • Coordinate with HRSA stakeholders to prioritize backlog items based on fraud risk impact, EPLC gate requirements, and HRSA program office readiness. Stakeholder Liaison and Communication • Serve as the primary liaison between HRSA fraud program offices and the technical delivery team; translate government feedback from sprint reviews into actionable backlog items. • Prepare and present sprint demo materials and stakeholder briefing summaries; document HRSA decisions and action items from all program meetings. • Support the Program Manager in producing required EPLC deliverables that require business input: Use Case Documents, Interface Requirements Specifications, and Transition Plans. HITL Workflow Design Support • Collaborate with the AI Agent / HITL Engineer to design analyst-facing review queues in UiPath Apps; define case prioritization logic, routing rules, and disposition workflow requirements. • Document HRSA analyst workflow patterns and configure HITL interface requirements so that AI-generated risk flags are presented in context usable for real-world fraud investigations.

Requirements

Bachelor’s degree in Business Administration, Public Administration, Health Informatics, Information Systems, or a closely related field.
Minimum 4 years of experience as a business analyst, program analyst, or requirements analyst on federal IT or health program contracts.
Demonstrated experience supporting HHS, CMS, OIG, HRSA, or comparable civilian agency programs with a focus on grants management, improper payments, or program integrity.
Working knowledge of federal fraud, waste, and abuse (FWA) frameworks: HHS OIG guidance, Improper Payments Elimination and Recovery Improvement Act (IPERIA), or equivalent.
Experience writing user stories and acceptance criteria for Agile/SAFe delivery teams; familiarity with tools such as Jira, Azure DevOps, or equivalent backlog management platforms.
Ability to facilitate requirements workshops and stakeholder meetings with federal government program offices; strong verbal and written communication skills.

Nice To Haves

US Citizenship
Ability to obtain and maintain an HHS Background Investigation (Public Trust) suitability determination.

Responsibilities

Facilitate structured requirements workshops with HRSA program stakeholders (OIG, Grants Division, FDMP program office) to elicit and document business requirements for fraud detection, anomaly flagging, and case management workflows.
Translate business requirements into user stories, acceptance criteria, and process flows; maintain a traceable requirements matrix (RTM) throughout the EPLC lifecycle.
Review and validate EPLC planning deliverables (Business Requirements Documents, Concept of Operations, System Requirements Specifications) to ensure they accurately reflect HRSA’s fraud detection intent.
Apply working knowledge of federal grant fraud, waste, and abuse (FWA) patterns to inform model design decisions: improper payment types, duplicate entity schemes, inflated cost reports, and sub-awardee integrity risks across HRSA grant programs.
Support the AI/ML Lead Engineer in defining supervised classification labels, anomaly detection thresholds, and SHAP feature interpretation from a business-rules perspective.
Validate model outputs and HITL review queues against known FWA patterns; flag false-positive risks and provide business-logic guardrails to data science team.
Contribute to the design of the Portfolio Risk Manager agent’s risk scoring logic and grantee-level threshold calibration; ensure scoring outputs are interpretable and defensible for HRSA investigators.
Own and maintain the product backlog in coordination with the Program Manager and AI/ML Lead Engineer; write well-formed user stories and acceptance criteria for all sprint deliverables.
Facilitate Agile ceremonies including sprint planning, backlog refinement, sprint review, and retrospective in accordance with the program’s SAFe-aligned delivery cadence.
Coordinate with HRSA stakeholders to prioritize backlog items based on fraud risk impact, EPLC gate requirements, and HRSA program office readiness.
Serve as the primary liaison between HRSA fraud program offices and the technical delivery team; translate government feedback from sprint reviews into actionable backlog items.
Prepare and present sprint demo materials and stakeholder briefing summaries; document HRSA decisions and action items from all program meetings.
Support the Program Manager in producing required EPLC deliverables that require business input: Use Case Documents, Interface Requirements Specifications, and Transition Plans.
Collaborate with the AI Agent / HITL Engineer to design analyst-facing review queues in UiPath Apps; define case prioritization logic, routing rules, and disposition workflow requirements.
Document HRSA analyst workflow patterns and configure HITL interface requirements so that AI-generated risk flags are presented in context usable for real-world fraud investigations.