FWA Payment Integrity Data Analyst III
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Job Description
Data Analyst III at CareSource developing and managing analyses related to Fraud, Waste, and Abuse. Collaborating with various departments to support decision-making and validate vendor deliverables.
Responsibilities:
- Develop, implement, manage and present in-depth analyses for Fraud, Waste, and Abuse.
- Lead and implement data analytic ideation and R&D activities.
- Validate Program Integrity vendor deliverables and results.
- Monitor emerging internal and external FWAE data vulnerabilities and trends.
- Identify trends and patterns using standard corporate processes and data sources.
- Conduct outcome analyses to determine impact and effectiveness.
- Generate graphics summarizing analyses for communication to appropriate parties.
- Collaborate with the Legal Department, generating data for support Legal proceedings.
- Perform data analyses in support of both the SIU Program Integrity and Audit Functions.
Requirements:
- Bachelor's degree or equivalent years of relevant work experience in Healthcare Data Analytics required
- Seven (7) years of experience in data analysis, FWA Ideation and/or analytic programming required
- Seven (7) years Health care delivery and/or payer experience required
- Extensive experience with Data Visualization / Dashboard tools (Power BI) required
- Extensive experience using SQL for analytics projects, including databases queries required
- Three (3) years of experience with Medicare/Medicaid required
- Healthcare management experience/exposure required
- Clinical experience is preferred
Benefits:
- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
- Professional development
- Bonuses
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