SVRS Manager

Peraton•,

14h•$104,000 - $166,000•Remote

About The Position

SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse. We are looking to add an SVRS Manager to our SGS team of experienced statisticians who support healthcare program integrity through rigorous sampling and analysis. The SVRS Manager provides operational and team leadership to a group of statisticians responsible for identifying and providing strong statistical and data analytic support for the UPIC to ensure successful outcomes for healthcare program integrity activities performed. A key responsibility of this position is overseeing the development and implementation of sampling plans and statistical approaches used to support case development activities supporting investigative and audit efforts addressing fraud, waste, and abuse. The SVRS Manager works in close partnership with the Chief Statistician, who serves as the subject matter expert and technical advisor to the contract and team, providing strategic guidance on sampling and extrapolation methodologies. Together, they ensure that the sampling and extrapolation methodologies used to project overpayments from the sample to the universe comply with CMS requirements (including IOM 100‑08) and applicable state policies. The SVRS Manager ensures that data extraction processes, analytical workflows, and statistical tools are effectively utilized to support case development by calculating a statistically sound overpayment that supports recoupment actions for the Medicare and Medicaid programs. This role partners with Medical Review, Audits, Investigations, and Project Development teams to ensure analytical outputs are accurate, defensible, and aligned with program integrity goals. In addition to these responsibilities, the SVRS Manager oversees the operational management of the unit, including establishing goals, objectives, and work plans for the team, motivating, coaching, and evaluating staff performance, allocating resources, managing workload priorities, and reporting unit activity, developing, administering, and managing the unit’s budget, overseeing compensation decisions and ensuring adherence to corporate policies, and recruiting, training, and developing staff to support organizational needs. This position requires strong operational leadership, the ability to lead a high‑performing team of statisticians, and the commitment to advancing investigative, audit, and compliance efforts addressing fraud, waste, and abuse in close coordination with the Chief Statistician.

Requirements

Master’s degree in statistics or a related field (e.g., psychometrics, biostatistics, econometrics, mathematics) or a PhD in a related field
10 years of professional experience, including supervisory or lead experience
Knowledge of Medicare and Medicaid programs
Experience working with healthcare claims data, including CPT/HCPCS and diagnosis codes
Prior experience in the health insurance industry, a utilization review firm, or a healthcare claims processing organization, particularly in roles involving sampling, estimation, extrapolation, or related activities
Significant coursework and practical experience in sampling and estimation methodologies, including interpreting statistical results
Experience with SAS or other statistical programming tools
High proficiency with Microsoft Office, especially Excel, Word, PowerPoint, and Access
Experience with Business Objects or equivalent reporting/analytics tools
Excellent analytical, quantitative, organizational, and communication skills
Strong interpersonal skills and the ability to work both independently and collaboratively
Ability to collaborate with internal and external stakeholders to gather requirements and ensure accuracy and quality of analytical deliverables
U.S. citizenship required

Nice To Haves

In‑depth knowledge of Medicare and Medicaid programs, including laws, rules, regulations, and payment policies
Working knowledge of Python, Databricks, or R
Experience supporting program integrity, fraud investigations, or law‑enforcement‑related analytical work
Experience developing or reviewing statistical methodologies for sampling, projections, or extrapolations
Familiarity with large‑scale healthcare datasets and data‑warehousing environments
Ability to identify and resolve operational problems, with an understanding of how decisions affect broader departmental and contract outcomes
Ability to guide others—internally and externally—toward adopting improved approaches or perspectives through collaboration, clarity, and sound reasoning
Ability to adjust departmental plans and priorities to meet short‑term service needs and contract objectives

Responsibilities

Provides operational and team leadership to a group of statisticians responsible for identifying and providing strong statistical and data analytic support for the UPIC to ensure successful outcomes for healthcare program integrity activities performed.
Oversees the development and implementation of sampling plans and statistical approaches used to support case development activities supporting investigative and audit efforts addressing fraud, waste, and abuse.
Ensures that sampling and extrapolation methodologies used to project overpayments from the sample to the universe comply with CMS requirements (including IOM 100‑08) and applicable state policies.
Ensures that data extraction processes, analytical workflows, and statistical tools are effectively utilized to support case development by calculating a statistically sound overpayment that supports recoupment actions for the Medicare and Medicaid programs.
Partners with Medical Review, Audits, Investigations, and Project Development teams to ensure analytical outputs are accurate, defensible, and aligned with program integrity goals.
Oversees the operational management of the unit, including establishing goals, objectives, and work plans for the team.
Motivates, coaches, and evaluates staff performance.
Allocates resources, manages workload priorities, and reports unit activity.
Develops, administers, and manages the unit’s budget.
Oversees compensation decisions and ensures adherence to corporate policies.
Recruits, trains, and develops staff to support organizational needs.