Develop, implement, manage and present in-depth analyses for Fraud, Waste, and Abuse.
Lead and implement data analytic ideation and R&D activities.
Validate Program Integrity vendor deliverables and results.
Monitor emerging internal and external FWAE data vulnerabilities and trends.
Identify trends and patterns using standard corporate processes and data sources.
Conduct outcome analyses to determine impact and effectiveness.
Generate graphics summarizing analyses for communication to appropriate parties.
Collaborate with the Legal Department, generating data for support Legal proceedings.
Perform data analyses in support of both the SIU Program Integrity and Audit Functions.

Bachelor's degree or equivalent years of relevant work experience in Healthcare Data Analytics required
Seven (7) years of experience in data analysis, FWA Ideation and/or analytic programming required
Seven (7) years Health care delivery and/or payer experience required
Extensive experience with Data Visualization / Dashboard tools (Power BI) required
Extensive experience using SQL for analytics projects, including databases queries required
Three (3) years of experience with Medicare/Medicaid required
Healthcare management experience/exposure required
Clinical experience is preferred

FWA Payment Integrity Data Analyst III

Key skills