Healthcare Business Analyst
Reveleer
SQLTableau
Salary
💰 $100,000 - $120,000 per year
Job Level
Senior
About the role
- Lead a team analyzing and interpreting complex healthcare data to support CMS in detecting and preventing fraud, waste, and abuse (FWA)
- Work closely with cross-functional teams, including policy analysts, healthcare professionals, and IT specialists, to support data-driven decision-making
- Provide technical assistance and training to team members on data analysis tools and methodologies
- Analyze large datasets related to Medicare programs to identify trends, patterns, and anomalies indicative of FWA
- Conduct statistical analyses and develop predictive models to support investigations and enhance program integrity
- Utilize machine learning techniques to detect and prevent fraudulent activities
- Collect, clean, and preprocess data from various sources to ensure data quality and integrity
- Maintain and update databases and data systems as necessary
- Create detailed reports and visualizations to communicate findings to stakeholders
- Present data insights and recommendations to CMS leadership and other relevant parties
- Ensure compliance with all relevant data privacy and security regulations, including HIPAA
- Implement best practices for data governance and management
Requirements
- Bachelor's degree in Data Science, Statistics, Computer Science, Applied Mathematics, or a related field
- Master’s degree preferred
- Minimum of 3 years of experience in data science, with a focus on healthcare data
- Minimum of 3 years of experience managing a healthcare-focused team of Data SMEs
- Experience in federal health programs, specifically supporting Medicare data and programs
- Familiarity with CMS data systems and regulatory requirements
- Experience in supporting data analysis within the context of program integrity, fraud, waste, abuse, and investigations (preferred)
- Knowledge of healthcare policy and regulatory environments (preferred)
- Certification in data science or related fields (preferred)
- Experience conducting statistical analyses and developing predictive models
- Experience utilizing machine learning techniques to detect and prevent fraudulent activities
- Experience collecting, cleaning, and preprocessing data from various sources
- Experience maintaining and updating databases and data systems
- Experience creating detailed reports and visualizations for technical and non-technical audiences
- Knowledge of data privacy and security regulations, including HIPAA
- Experience implementing best practices for data governance and management
- Ability to provide technical assistance and training to team members on data analysis tools and methodologies
