- Location
- Alexandria, Virginia, United States · published
- Workplace
- Remote
- Type
- Full-time
- Department
- Operations
- Seniority
- Senior
- Source
- Workable
Description
About Us
Integrity Management Services, Inc. (IntegrityM) is an award-winning, women-owned small business specializing in assisting government and commercial clients in compliance and program integrity 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 thrive off of these fundamental elements that make IntegrityM a great place 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!
In this role, the Senior Data Analyst possesses an in-depth knowledge of health care systems, expertise with healthcare claims (Medicare and Medicaid), intermediate computer and software skills, and the ability to produce 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:
- Develops and implements models and analytical approaches that support Medicare and Medicaid fraud, waste, and abuse (FWA) detection efforts. Applies healthcare data and policy expertise to known fraud schemes to hypothesize the “footprints” such schemes may leave in the data.
- Designs and executes tests to validate these hypotheses and leverages findings to build effective fraud detection models.
- Detects anomalies in healthcare data and investigates potential indicators of fraudulent activity. Identifies outliers that demonstrate patterns consistent with fraud, waste, or abuse.
- Constructs advanced models for targeted analysis using tools such as Python, R, SQL and SAS.
- Extracts and manipulates Medicare, Medicaid, and other healthcare claims data housed in cloud environments using software tools including Python, R, SQL, SAS and others as appropriate to the task.
- Designs and executes targeted analyses and develops related materials to support project goals.
- Maintains ongoing knowledge of Medicare and Medicaid policies, including updates and changes. Evaluates the implications of policy changes on fraud detection models and adjusts methodologies accordingly.
- Participates in and supports testing sprints and related project initiatives.
- Provides subject matter expertise and guidance to Statistical and Data Analysts.
- Assists in task execution and ensures quality of project deliverables through peer review and technical assistance.
- Prepares detailed analytical reports.
- May serve as a Team Lead, responsible for planning, coordinating, and documenting project activities, managing team performance, and serving as a primary liaison with clients.