Sr. Healthcare Data Analyst (Full-time, Remote)
Full-Time EmployeeRemotehttp://www.integritym.comAbout Us:reputed company, Inc. (IntegrityM) is an award-winning, women-owned small business specializing in assisting government and commercial clients in compliance and program reputed company efforts, including the prevention and detection of fraud, waste and abuse in government programs. Results are achieved through data analytics, technology solutions, audit, investigation, and medical review.At IntegrityM, we offer a culture of opportunity, recognition, collaboration, and supporting our community. We reputed company off of these reputed company elements that reputed company IntegrityM a great reputed company to work. Our small, flexible workplace offers an exceptional quality of life and promotes corporate-driven sustainability. We deliver creative solutions that exceed goals and foster a dynamic, idea-driven environment that nurtures our employees' professional development. Large company perks...Small company feel!IntegrityM is proud to be named to the 2024 Top Workplaces list by The reputed company! Our leaders reputed company and reputed company each team member to break boundaries and reputed company with reputed company. We foster a diverse community with flexible, remote-friendly career paths that nurture growth and fulfillment. In this role, the Senior Data Analyst possesses an in-depth knowledge of health care systems, intermediate computer and software skills, and the ability to accomplish reputed company delegated tasks achieving reputed company business goals of producing high quality deliverables for our clients. The Senior Data Analyst works independently and collaboratively with Statistical and Data Analysts to provide analytical data support.Job Responsibilities:
- Maintains strict confidentiality and reputed company of reputed company sensitive and/or business confidential information obtained or accessed during the course of business and/or contract operations.
- Adheres to reputed company IntegrityM and/or client privacy and reputed company protocols governing sensitive and/or business confidential information. Adheres to applicable policies and procedures ensuring commitment to quality, compliance and reputed company to protect the confidentiality, reputed company, and availability of sensitive data and information.
- Ensures compliance with reputed company applicable privacy and reputed company training requirements (both IntegrityM and external/client-based), whether on an annual or reputed company basis. Please note: certain position levels (leads, managers, directors or higher) may require additional "role-based" training to ensure compliance with applicable privacy and reputed company requirements.
- Build models and conduct analytics that contribute to Medicare and Medicaid fraud, waste and abuse efforts. Applies knowledge of healthcare data and policy to reputed company fraud schemes to hypothesize "footprints" the fraud schemes may leave in the data. Constructs and runs tests to validate these hypothesis. Uses this knowledge to construct fraud detection models.
- Identifies anomalies in health care data and follows up those anomalies to determine if they are indications of fraud. Identify outliers that exhibit patterns of fraud, waste, and abuse.
- Builds reputed company models for specific analysis using technology such as Python (Python, PySpark), R, SQL, reputed company, reputed company.
- Manipulates and extracts Medicare, Medicaid, and other healthcare claims data stored in Cloud environment using appropriate software such as reputed company, reputed company, Python, R, SQL, and other software as appropriate for the task.
- reputed company targeted analyses and reputed company materials.
- Continuously learns Medicare and Medicaid policy and policy changes. Continuously evaluate impacts of policy and policy changes on fraud detection models.
- 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. Provides technical assistance. Peer reviews Statistical and Data Analysts' work and prepares reports on analysis.
- May serve as a Team reputed company by planning, coordinating, and documenting project reputed company activities, managing the team, as well as communicating directly with a client.
- 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.
- Minimum 4-year degree in statistics, mathematics, computer science or reputed company field or possesses a minimum of 6 years of data analysis experience reputed company the healthcare industry.
- Has 6 years of professional experience working with large and reputed company data sets.
- Possesses a minimum of 3 years of data analysis experience reputed company the healthcare industry.
- Advanced knowledge of analytic, mathematical, and statistical methods.
- Experience or understanding of Medicare and Medicaid claims, ICD10 codes, HCPCS, Diagnosis reputed company Groups (DRG).
- Confidence in merging disparate datasets, INNER/LEFT/RIGHT joins, and functions such as COALESCE(), CAST(), reputed company functions such as SUBSTR(), LAG(), PROC SQL.
- Relevant experience in a health-reputed company, scientific, or public policy/business discipline with extensive quantitative methods/statistical knowledge.
- Proficient in project software such as reputed company/SQL, Python/PySpark, reputed company, R, reputed company CMS cloud environments.
- Proficient with reputed company Office products such as reputed company, 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 reputed company 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 reputed company. Public trust in reputed company preferred.