Fraud Waste and Abuse Healthcare Analytics Manager

Insight Global • Milford Mill, MD

411d • $141,440 - $141,440

About The Position

The Fraud Waste and Abuse Healthcare Analytics Manager will lead a team of 10-15 professionals, including Data Scientists and Business Intelligence Analysts, to develop and oversee FWA models and algorithms within a multi-payer data warehouse. This role emphasizes collaboration with various stakeholders to produce meaningful analyses and predictive analytics, while also ensuring the design and maintenance of automated data pipelines. The manager will document processes to optimize business efficiencies and handle program management tasks such as project scheduling and client collaboration.

Requirements

• Master's Degree or equivalent experience in Data Science or related field.
• Experience in healthcare fraud, waste, and abuse analytics using claims data in Medicare/Medicaid.
• Experience in client relation activities and synthesizing customer requirements.
• Proven ability to present FWA analytic outcomes to clients and stakeholders.
• Prior experience managing multi-person data analytics teams with a focus on healthcare data.
• Experience in technical working groups and stakeholder collaboration.
• Familiarity with Amazon Web Services (AWS) cloud and/or Snowflake data warehouse environments.
• Exceptional problem-solving abilities and strong organizational skills.

Nice To Haves

• Experience in strategic business planning and governance activities across multiple entities.
• Ability to work in a fast-paced, team-oriented environment with minimal supervision.

Responsibilities

• Lead a team of data professionals including Data Scientists and Business Intelligence Analysts.
• Plan and oversee the development of Fraud Waste and Abuse (FWA) models and algorithms.
• Facilitate collaboration with program areas, clients, and stakeholders for meaningful analyses.
• Direct the design and maintenance of automated data pipelines ensuring quality and compliance.
• Document processes and strategies to optimize business efficiencies.
• Handle program management tasks such as project scheduling and EVM reporting.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• Health Savings Account (HSA) options
• Flexible Spending Account (FSA) options
• Dependent Care Flexible Spending Account (DCFSA) options
• 401k retirement account access with employer matching
• Paid sick leave
• Paid time off as provided by applicable law

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Administrative and Support Services
• Education Level: Master's degree