Company

Booz Allen Hamilton, Inc.See more

addressAddressVirginia, United States
type Form of workFull-Time
CategoryInformation Technology

Job description

Healthcare Fraud Data Analyst, Senior
Key Role:
Grow with our compliance and anti-fraud team with the responsibility to perform advanced analyses to ensure the integrity of the client's health programs. Generate innovative ideas for creative solutions and collaborate with other subject matter experts to ensure specialized topics are appropriately addressed. Conduct active surveillance of notable or emerging trends in program payment structures. Assist the client in efforts to identify and assess exposure or vulnerability to fraud, waste, and abuse in programs and provide support and assistance to state program integrity functions. Assess and monitor the impact of policy and payment changes on access to care, beneficiary health outcomes, and program payments, while applying healthcare payer expertise to address payer strategic and operational priorities.
Basic Qualifications:

  • 5+ years of experience using statistical methodologies to identify vulnerabilities in Medicare, Medicaid, and Managed Care programs
  • Experience with health care information, for example health claims data and ICD-10 codes, physician specialty codes, survey and certification data, and provider and supplier identifiers
  • Experience in statistical detection of potential Healthcare Fraud and abuse, using tools such as predictive modeling, development of mathematical models, neural networks, healthcare data analytics, and data mining or other analytical methods
  • Experience in data access tools, such as SAS, SQL, Python, and R
  • Experience in the design, management, and oversight of databases
  • Experience with Medicare claims and pharmacy drug data
  • Knowledge of Medicare Parts A, B, C, D, and DME benefits
  • Ability to obtain a security clearance
  • Bachelor's degree in a healthcare, science, public health, policy, statistics, mathematics, or economics field

Additional Qualifications:
  • Experience delivering sensitive information and technical content to a wide range of stakeholders and using a variety of delivery techniques.
  • Experience in facilitating large meetings with both internal and external audiences.
  • Knowledge of the federal procurement and proposal process, and contract management principles.
  • Knowledge of CMS claims data, including Medicare, Medicaid, and Marketplace, in the IDR or CCW environment with Fee-for-Service (FFS), Medicare Advantage encounter data, Medicaid data in the Transformed Medicaid Statistical Information System (T-MSIS), or Prescription Drug Event (PDE) data.
  • Knowledge of CMS program integrity related systems and resources
  • Ability to apply automation techniques to drive insights and efficiency
  • Ability to work collaboratively and build effective working relationships
  • Accredited Healthcare Fraud Investigator (AHFI), Health Care Anti-Fraud Associate (HCAFA), Certified Insurance Fraud Investigator (CIFI), Certified Financial Crimes Investigator (CFCI), Certified Fraud Examiner (CFE), Certified in Healthcare Compliance (CHC), or CPC, CEMA, or CPMA certifications

Clearance:
Applicants selected will be subject to a security investigation and may need to meet eligibility requirements for access to classified information.
Create Your Career:
Grow With Us
Your growth matters to us-that's why we offer a variety of ways for you to develop your career. With professional and leadership development opportunities like upskilling programs, tuition reimbursement, mentoring, and firm-sponsored networking, you can chart a unique and fulfilling career path on your own terms.
A Place Where You Belong
Diverse perspectives cultivate collective ingenuity. Booz Allen's culture of respect, equity, and opportunity means that, here, you are free to bring your whole self to work. With an array of business resource groups and other opportunities for connection, you'll build your community in no time.
Support Your Well-Being
Our comprehensive benefits package includes wellness programs with HSA contributions, paid holidays, paid parental leave, a generous 401(k) match, and more. With these benefits, plus the option for flexible schedules and remote and hybrid locations, we'll support you as you pursue a balanced, fulfilling life-at work and at home.
Your Candidate Journey
At Booz Allen, we know our people are what propel us forward, and we value relationships most of all. Here, we've compiled a list of resources so you'll know what to expect as we forge a connection with you during your journey as a candidate with us.
Compensation
At Booz Allen, we celebrate your contributions, provide you with opportunities and choices, and support your total well-being. Our offerings include health, life, disability, financial, and retirement benefits, as well as paid leave, professional development, tuition assistance, work-life programs, and dependent care. Our recognition awards program acknowledges employees for exceptional performance and superior demonstration of our values. Full-time and part-time employees working at least 20 hours a week on a regular basis are eligible to participate in Booz Allen's benefit programs. Individuals that do not meet the threshold are only eligible for select offerings, not inclusive of health benefits. We encourage you to learn more about our total benefits by visiting the Resource page on our Careers site and reviewing Our Employee Benefits page.
Salary at Booz Allen is determined by various factors, including but not limited to location, the individual's particular combination of education, knowledge, skills, competencies, and experience, as well as contract-specific affordability and organizational requirements. The projected compensation range for this position is $75,600.00 to $172,000.00 (annualized USD). The estimate displayed represents the typical salary range for this position and is just one component of Booz Allen's total compensation package for employees. This posting will close within 90 days from the Posting Date.
Work Model
Our people-first culture prioritizes the benefits of flexibility and collaboration, whether that happens in person or remotely.
  • If this position is listed as remote or hybrid, you'll periodically work from a Booz Allen or client site facility.
  • If this position is listed as onsite, you'll work with colleagues and clients in person, as needed for the specific role.

EEO Commitment
We're an equal employment opportunity/affirmative action employer that empowers our people to fearlessly drive change - no matter their race, color, ethnicity, religion, sex (including pregnancy, childbirth, lactation, or related medical conditions), national origin, ancestry, age, marital status, sexual orientation, gender identity and expression, disability, veteran status, military or uniformed service member status, genetic information, or any other status protected by applicable federal, state, local, or international law.
Refer code: 9291773. Booz Allen Hamilton, Inc. - The previous day - 2024-05-21 01:47

Booz Allen Hamilton, Inc.

Virginia, United States
Popular Senior Data jobs in top cities
Jobs feed

Truck Driver Class A CDL Solo

Ryder

Grand Island, NE

From $1,682 a week

Orthopedic RN Case Manager *URGENT NEED*

Vrcd Nursing Company

Grand Junction, CO

$70 an hour

Operating Room RN Full Time

Thinksoft Technologies Llc

Grand Junction, CO

$55 - $60 an hour

Route Sales Support Driver

Vestis

Grand Island, NE

$41K - $51.9K a year

CDL-A Company Truck Driver Teams

Don Hummer Trucking Corporation

Grand Island, NE

$200,000 a year

Medical Records Specialist

St. David's North Austin Medical Center

Austin, TX

Registered Nurse - Outpatient Procedure Center - PRN

Family Health West

Fruita, CO

$34.50 - $50.66 an hour

Registered Nurse

Touch Of Care Hospice

Grand Junction, CO

$35 - $45 an hour

EVS Floor Tech

Medical City Fort Worth

Fort Worth, TX

Rapid Response Crisis RN - $2,722/week

1St Ameristaff

Grand Junction, CO

$2,722 a week

Share jobs with friends

Related jobs

Healthcare Fraud Data Analyst, Senior

Senior Data Scientist - Payer Analytics

Cvs Health

Boston, MA

just now - seen

Senior Business Reporting & Data Analyst

Discover Financial Services

Illinois, United States

6 hours ago - seen

Senior Data Engineer, Blockchain

Circle

Chicago, IL

6 hours ago - seen

Senior Manager, Technical Production - League Studios, Data

Riot Games

United States

7 hours ago - seen

Senior Data Analyst - Analytics Engineering

Kraken

United States

8 hours ago - seen

Senior Data Scientist

Entefy

United States

24 hours ago - seen

Senior Data Consultant, Sales & Marketing

Caterpillar

Irving, TX

yesterday - seen

Senior Data Privacy Compliance Officer - Legal & Compliance

Bloomberg

New York, NY

yesterday - seen

Senior Data Scientist - Operations Research

Veho

United States

yesterday - seen

Senior Specialist Data Science -- IA&IO

Merck

Rahway, NJ

2 days ago - seen

Senior Data Analyst - IT

United Airlines

Chicago, IL

2 days ago - seen

Senior Data Scientist - Ecommerce

Mercury

United States

3 days ago - seen

Senior Technology Strategist - SW Dev

Ntt Data, Inc.

Chantilly, VA

3 days ago - seen

Senior Cloud Architect - AWS and Azure

Ntt Data, Inc.

District of Columbia, United States

3 days ago - seen

Senior Engagement Manager

Ntt Data, Inc.

Chantilly, VA

3 days ago - seen

Senior Software Engineer - Data Engineer

Nvidia

$148,000 - $276,000 a year

Santa Clara, CA

4 days ago - seen