Senior Data Analyst - Fraud, Waste, and Abuse - Remote
About The Position
The Fraud, Waste, and Abuse (FWA) Analyst plays a critical role in safeguarding state Medicaid programs by identifying, analyzing, and preventing fraudulent activities within Medicaid claims. You will be working with a State Government Product and Data Mining team. Your primary responsibility will be to assist in the development and deployment of algorithms designed to support program integrity across various platforms and states plus support our fraud and abuse detection product and services. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Requirements
- 5+ years of experience writing advanced SQL queries
- 5+ years of fraud, waste and abuse data mining experience
- 5+ years of intermediate to advanced proficiency in Microsoft Excel, Word, Teams, PowerPoint, and Outlook
- 4+ years of data analysis experience working with database structures
- 4+ years of healthcare claims experience
Nice To Haves
- Industry certifications: Certified Professional Coder (CPC) or Certified Fraud Examiner (CFE)
- Experience with statistical analysis of data
- Experience with Rally
- Experience with data visualization tools and report interpretation
- Knowledge of Medicaid policy and real-life fraud, waste, abuse schemes
- Knowledge of healthcare claim adjudication systems
Responsibilities
- Write simple to complex SQL statements to extract data for client inquiry and research
- Utilize production reports to perform research and assess quality of overall data
- Analyze and interpret data to identify FWA trends and patterns within claims data
- Applies creative and analytical thinking to uncover and resolve complex fraud, waste, and abuse patterns
- Engage with clients to triage and manage incoming operational inquiries and tasks
- Identifies innovative approaches to resolve non-standard problems and deliver effective outcomes
- Interface professionally with data engineers, software engineers and other development teams
- Troubleshoot client operational issues quickly and comprehensively
- Support, train and mentor fellow analysts and developers
- Influences and provides input to improvement of operational processes
- Work is self-directed, less structured, more complex issues
- Function well within a matrix organization (E.g. - supporting multiple leaders)
- Proficient in research, interpreting, and analyzing diverse and complex data, and assessing data quality
- Proficiency with excel & visualization tools
- Intermediate to advanced computer skills consisting of Teams, Microsoft Excel, Outlook, Word, and Power Point
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
