Payment Integrity Analytics, Senior Analyst

Gainwell Technologies LLC

6d•Remote

About The Position

As a Payment Integrity Analytics, Senior Analyst at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.

Requirements

4+ years Apply statistical and analytical methods to identify potential FWA activity using healthcare claims data
Experience with Medicaid programs for State of Indiana
4+ years Prepare reports and presentations documenting analytic methods and results for internal and external customers
4+ years Work on complex projects to identify and validate new FWA detection models and methods including the analysis of data inputs and outputs

Responsibilities

Responsible for planning and conducting statistical and epidemiological analysis of health care data in support of the Gainwell Technologies LLC Mission, Vision, Key Quality Strategies, and Values.
Design and conduct analysis of health care databases using SQL, PowerBI, or other statistical analysis software and other relevant tools for multiple health care projects.
Serve as an analytic resource within multi-disciplinary project teams.
Provide statistical and analytical input to payment integrity model design, sampling methodology, analysis, and reporting to assure desired outcome.
Work may focus on more complex projects.
Develop data formatting and cleaning criteria for data from various sources and evaluates relevant data.
Coordinate across data platforms and teams to ensure data accuracy and proper data analysis results
Prepare reports and presentations documenting analytic methods and results.
Conduct ad hoc analyses of data as requested by hospitals, clinicians, and internal customers.
Mentor more junior team members