
Fraud Business Analyst, SME
Node.Digital
full-time
Posted on:
Location Type: Remote
Location: United States
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Tech Stack
About the role
- Facilitate structured requirements workshops with HRSA program stakeholders (OIG, Grants Division, FDMP program office) to elicit and document business requirements for fraud detection, anomaly flagging, and case management workflows.
- Translate business requirements into user stories, acceptance criteria, and process flows; maintain a traceable requirements matrix (RTM) throughout the EPLC lifecycle.
- Review and validate EPLC planning deliverables (Business Requirements Documents, Concept of Operations, System Requirements Specifications) to ensure they accurately reflect HRSA’s fraud detection intent.
- Apply working knowledge of federal grant fraud, waste, and abuse (FWA) patterns to inform model design decisions: improper payment types, duplicate entity schemes, inflated cost reports, and sub-awardee integrity risks across HRSA grant programs.
- Support the AI/ML Lead Engineer in defining supervised classification labels, anomaly detection thresholds, and SHAP feature interpretation from a business-rules perspective.
- Validate model outputs and HITL review queues against known FWA patterns; flag false-positive risks and provide business-logic guardrails to data science team.
- Contribute to the design of the Portfolio Risk Manager agent’s risk scoring logic and grantee-level threshold calibration; ensure scoring outputs are interpretable and defensible for HRSA investigators.
- Own and maintain the product backlog in coordination with the Program Manager and AI/ML Lead Engineer; write well-formed user stories and acceptance criteria for all sprint deliverables.
- Facilitate Agile ceremonies including sprint planning, backlog refinement, sprint review, and retrospective in accordance with the program’s SAFe-aligned delivery cadence.
- Coordinate with HRSA stakeholders to prioritize backlog items based on fraud risk impact, EPLC gate requirements, and HRSA program office readiness.
- Serve as the primary liaison between HRSA fraud program offices and the technical delivery team; translate government feedback from sprint reviews into actionable backlog items.
- Prepare and present sprint demo materials and stakeholder briefing summaries; document HRSA decisions and action items from all program meetings.
- Collaborate with the AI Agent / HITL Engineer to design analyst-facing review queues in UiPath Apps; define case prioritization logic, routing rules, and disposition workflow requirements.
- Document HRSA analyst workflow patterns and configure HITL interface requirements so that AI-generated risk flags are presented in context usable for real-world fraud investigations.
Requirements
- Bachelor’s degree in Business Administration, Public Administration, Health Informatics, Information Systems, or a closely related field.
- Minimum 4 years of experience as a business analyst, program analyst, or requirements analyst on federal IT or health program contracts.
- Demonstrated experience supporting HHS, CMS, OIG, HRSA, or comparable civilian agency programs with a focus on grants management, improper payments, or program integrity.
- Working knowledge of federal fraud, waste, and abuse (FWA) frameworks: HHS OIG guidance, Improper Payments Elimination and Recovery Improvement Act (IPERIA), or equivalent.
- Experience writing user stories and acceptance criteria for Agile/SAFe delivery teams; familiarity with tools such as Jira, Azure DevOps, or equivalent backlog management platforms.
- Ability to facilitate requirements workshops and stakeholder meetings with federal government program offices; strong verbal and written communication skills.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
business requirementsuser storiesacceptance criteriaprocess flowsrequirements traceability matrixfraud detectionanomaly detectionrisk scoring logicbacklog managementAgile methodologies
Soft Skills
facilitationcommunicationcollaborationstakeholder engagementpresentation skillsanalytical thinkingproblem-solvingorganizational skillsteam coordinationleadership