Healthcare Data Analyst

Job Summary

To support the detection and analysis of healthcare fraud, waste, and abuse, the full-time remote Healthcare Data Analyst will perform in-depth evaluations of claims data, utilize statistical modeling techniques, and communicate findings to stakeholders.

Key responsibilities:

• Conduct statistical research and analytics to support case development and fulfill data requests from health plans and law enforcement
• Utilize data mining and predictive modeling to identify anomalies in health plan claims data and develop leads from various sources
• Create dashboards and visualizations to effectively communicate analytic findings to internal and external stakeholders

Required qualifications:

• Bachelor's degree in Mathematics, Statistics, Healthcare Administration, Data Science, or a related field; preference for candidates with a Master's degree
• 3+ years of experience analyzing healthcare claims data specifically related to fraud, waste, and abuse investigations
• Proficiency in data visualization tools such as Tableau, Power BI, or Sigma
• Experience with programming languages such as SQL, Python, and R for data analysis
• Strong understanding of healthcare claims processes and relevant coding systems (ICD-9-CM, ICD-10-CM, CPT, HCPCS)