Senior Data Analyst

Analytica•Bethesda, MD

About The Position

Analytica is seeking a Senior Data Analyst with Medicare and/or Medicaid policy and claims data experience to develop advanced analytical solutions that identify aberrant provider billing and utilization patterns. The role involves working with large healthcare claims datasets and applying SQL, Python, statistical methods, and machine learning techniques to identify vulnerabilities, anomalous activity, and potential risks in Medicare and Medicaid programs. The analyst will collaborate with clients and project teams to define data requirements, address data challenges, develop and test models, and communicate analytical findings and recommendations. The position also involves researching emerging methods and tools, documenting analytical methods and findings, and monitoring compliance with Medicare and Medicaid billing requirements.

Requirements

Bachelor’s or Master’s degree in Data Analytics, Statistics, Health Policy, Public Health, or a related field.
Experience working with Medicare and/or Medicaid data.
Strong SQL skills working with large claims datasets, including the ability to trace joins and filters and clearly explain changes in record counts.
Proficiency in Python.
Strong knowledge of statistical programming concepts and best practices.
Experience developing machine learning models, including anomaly detection techniques such as Isolation Forest.
Experience with Databricks, Snowflake, or another notebook-based development environment.
Strong communication skills and the ability to present technical concepts and analytical findings to clients and project teams.

Nice To Haves

Master’s degree.
Program integrity experience.
Experience with MLflow and MLOps practices.
Experience with Esri or other geospatial mapping and analytics tools.
Experience with Tableau and data visualization techniques.
Ability to read and interpret SAS code.

Responsibilities

Gather and define data requirements and resolve data-related challenges in collaboration with client and project teams.
Develop and refine data models to identify vulnerabilities, anomalous activity, and potential risks within Medicare and Medicaid programs.
Analyze provider billing and utilization patterns using large healthcare claims datasets.
Consult and advise on data analysis, statistical modeling, and analytical techniques.
Research and evaluate new modeling methods, tools, market trends, and proven approaches.
Develop white papers and other documentation outlining analytical methods and findings.
Monitor compliance with Medicare and Medicaid billing requirements.
Perform testing and quality assurance for data models and analytical solutions.
Research emerging data concepts, technologies, and analytical approaches.
Communicate directly with customers and present findings, recommendations, and results to project teams and stakeholder groups.