Sr. Data Analyst (Full-time, Remote)

Integrity Management Services, Inc.•Alexandria, VA

8d•$70,000 - $100,000•Remote

About The Position

Integrity Management Services, Inc. (IntegrityM) is an award-winning, women-owned small business that supports government and commercial clients in compliance and program integrity, including preventing and detecting fraud, waste, and abuse. The Senior Data Analyst applies healthcare systems and claims expertise to deliver analytical support for Medicare and Medicaid fraud detection efforts, working independently and collaboratively with Statistical and Data Analysts. The role develops and validates analytical approaches, detects anomalous healthcare data, builds fraud detection models, and performs targeted analyses using healthcare claims data in cloud environments. It also involves monitoring Medicare and Medicaid policy changes, supporting testing sprints, providing technical guidance and peer review, and preparing detailed analytical reports. The employee may serve as a Team Lead, coordinating project activities, managing team performance, and acting as a primary client liaison. This is a full-time, remote position. Candidates must pass post-hire background screening and have wired and/or wireless internet access for remote work. The ability to obtain security clearance may be required depending on the client or contract. The U.S. remote annual salary range is $70,000–$100,000; final pay may vary based on work location and job-related factors.

Requirements

A four-year degree in statistics, mathematics, computer science, or a related field, or at least six years of data analysis experience within the healthcare industry.
Six years of professional experience working with large and complex data sets.
Advanced knowledge of analytic, mathematical, and statistical methods.
Experience with healthcare claims data, specifically Medicare and Medicaid claims.
Experience or understanding of ICD-10 codes, HCPCS, and Diagnosis Related Groups (DRG).
Ability to merge disparate datasets and use INNER, LEFT, and RIGHT joins, COALESCE(), CAST(), and SAS functions such as SUBSTR(), LAG(), and PROC SQL.
Relevant experience in a health-related, scientific, or public policy/business discipline, with extensive quantitative methods or statistical knowledge.
Proficiency with project software including SAS, Python, R, and/or SQL.
Proficiency with Microsoft Office products such as Excel, Word, PowerPoint, and Outlook.
Knowledge of analytic methodologies and principles.
Knowledge of program integrity data analytics.
Ability to respond to tasks or requests cooperatively and in a timely manner.
Adaptability to change and ability to initiate or identify change when necessary.
Strong customer service, organizational, and analytical skills.
Ability to perform complex mathematical calculations.
Excellent leadership and presentation skills.
Ability to work independently and as part of a team to deliver high-quality work.
Ability to multitask and prioritize assignments while meeting deadlines.
Must pass post-hire background screening checks.
For remote work, must have wired and/or wireless internet access.
Must be able to obtain security clearance if required by the client or contract.

Responsibilities

Develop and implement models and analytical approaches to support Medicare and Medicaid fraud, waste, and abuse detection.
Apply healthcare data and policy expertise to hypothesize data patterns associated with known fraud schemes.
Design and execute tests to validate hypotheses and use findings to build fraud detection models.
Detect anomalies in healthcare data, investigate potential indicators of fraud, and identify relevant outliers and patterns.
Construct advanced models for targeted analysis using tools such as Python, R, SQL, and SAS.
Extract and manipulate Medicare, Medicaid, and other healthcare claims data housed in cloud environments.
Design and execute targeted analyses and develop materials supporting project goals.
Maintain knowledge of Medicare and Medicaid policies, evaluate policy changes’ implications for fraud detection models, and adjust methodologies as needed.
Participate in and support testing sprints and related project initiatives.
Provide subject matter expertise and guidance to Statistical and Data Analysts.
Assist with task execution and ensure the quality of project deliverables through peer review and technical assistance.
Prepare detailed analytical reports.
May serve as a Team Lead by planning, coordinating, and documenting project activities, managing team performance, and serving as a primary client liaison.