Integrity Management Services is hiring a
Sr. Healthcare Data Analyst, Remote - United States

Summary

The job is for a Senior Data Analyst at Integrity Management Services, Inc., a women-owned small business specializing in compliance and program integrity efforts. The role involves using data analytics to detect fraud, waste, and abuse in government programs. The position requires a minimum of 4-year degree or 6 years of experience in data analysis within the healthcare industry.

Requirements

• Minimum 4-year degree in statistics, mathematics, computer science or related field or possesses a minimum of 6 years of data analysis experience within the healthcare industry
• Has 6 years of professional experience working with large and complex data sets
• Advanced knowledge of analytic, mathematical, and statistical methods
• Experience or understanding of Medicare and Medicaid claims, ICD10 codes, HCPCS, Diagnosis Related Groups (DRG)
• Confidence in merging disparate datasets, INNER/LEFT/RIGHT joins, and functions such as COALESCE(), CAST(), SAS functions such as SUBSTR(), LAG(), PROC SQL
• Relevant experience in a health-related, scientific, or public policy/business discipline with extensive quantitative methods/statistical knowledge
• Proficient in project software such as SAS/SQL, Python/PySpark, Snowflake, R, Databricks CMS cloud environments
• Proficient with Microsoft Office products such as Excel, Word, PowerPoint and Outlook
• Knowledge of analytic methodologies and principles
• Responds to tasks or requests in a cooperative and timely manner
• Demonstrates adaptability to change and initiates or identifies change when necessary
• Must be a team player
• Works collaboratively with team members to meet the needs of the organization
• Must be able to pass a public trust background check. Public trust in place preferred
• Must pass post hire background screening checks

Responsibilities

• Maintains strict confidentiality and security of all sensitive and/or business confidential information obtained or accessed during the course of business and/or contract operations
• Adheres to all IntegrityM and/or client privacy and security protocols governing sensitive and/or business confidential information
• Builds models and conduct analytics that contribute to Medicare and Medicaid fraud, waste and abuse efforts
• Identifies anomalies in health care data and follows up those anomalies to determine if they are indications of fraud
• Builds complex models for specific analysis using technology such as Python (Python, PySpark), R, SQL, SAS, Databricks
• Manipulates and extracts Medicare, Medicaid, and other healthcare claims data stored in Cloud environment using appropriate software such as SAS, Snowflake, Python, R, SQL, and other software as appropriate for the task
• Develop targeted analyses and related materials
• Continuously learns Medicare and Medicaid policy and policy changes
• Support and participate in testing sprints and projects
• Provides subject matter expertise and guidance to Statistical and Data Analysts in learning to complete their tasks and assuring the quality of project deliverables
• Effectively communicates with and between technical and non-technical end users, providing clear explanation of procedures used and results obtained from data analysis tasks
• Leads and/or participates in team projects and brainstorming sessions to assess various methodologies for study designs
• Remains informed regarding industry changes, trends, best practices, and applicable regulations and assesses impact of changes on the project
• Exercises appropriate discretion and independent judgment relating to company policies and practices in an effective, consistent, and professional manner