Healthcare Data Analyst

Job Summary

To support healthcare fraud detection efforts, the full-time remote Healthcare Data Analyst will analyze claims data, identify patterns of fraud, waste, and abuse, and communicate actionable insights 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 statistical modeling techniques to detect anomalies in health plan claims data
• Create dashboards and visualizations to effectively communicate findings to internal and external stakeholders

Required qualifications:

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