Senior Data Scientist - Remote!

At GDIT, people are our differentiator. Our work depends on a Fraud, Waste and Abuse (FWA) Data Scientist joining our team to support Centers for Medicare and Medicaid Services anti-fraud activities.

As a FWA Data Scientist supporting the Healthcare Fraud Prevention Partnership, you will be trusted to collaborate with Subject Matter Experts and other Data Scientists to create unique fraud detection methodologies within a multi-billion record database made up of a large partnership of public and private healthcare payers.

The GDIT HFPP Trusted Third Party is the only data warehouse of its type anywhere, bringing in many billions of healthcare claims from dozens of healthcare payers, including federal, state, and local plans both public and private. We use this data warehouse solely for fraud, waste, and abuse analytics.

The TTP is responsible for identifying overpayments, fraud leads, and meaningful insights about abusive billing behaviors through a cross-payer lens. Government and private healthcare organizations collaborated to form the HFPP as a public-private partnership to combat fraud, waste, and abuse.

HOW A SENIOR DATA ANALYST WILL MAKE AN IMPACT:

• This position will be responsible for development and execution activities in multi-payer environments by creating, reviewing, and maintaining statistical analysis plans, providing data interpretation, and generating reports in support of proposed research questions.

• The FWA Data scientist will develop statistical tests for FWA modeling results and provide predictive analytic statistical support.

• This position is responsible for preparing timelines for statistical project management and performs and interprets basic and complex analyses.

• The FWA Data Scientist will provide quality review on statistical analysis and programs plan to ensure consistency with protocol and adequacy to meet objectives defined in protocol, by collaborating with other statisticians and programmers to identify potential data problems from analytic queries and to take appropriate action to guide the resolution process.

• This position requires documenting analyses, creating summaries, and presenting written and verbal results for FWA study reports.

• The FWA Data Scientist will effectively communicate statistical and data-related concepts to non-statisticians (managers, researchers in other fields, etc.).

• This team member will be called upon to lead or co-lead small project teams as necessary.

WHAT YOU’LL NEED TO SUCCEED:

• Master’s Degree in Statistics or related field.

• 5 years of experience in statistical and computer-science related field(s).

• 5 years of experience using SAS or similar software, performing datamining and statistical modeling for healthcare Fraud, Waste and Abuse or other utilization review.

• 5 years client relation activities, ingesting and synthesizing customer requirements and effectively communicating complex healthcare analytic outcomes to client satisfaction.

• 5 years expertise in medical terminology and all healthcare coding systems (e.g., ICD-10, CPT, HCPCS, DRG and the like).

• 5 years of experience datamining for healthcare fraud, waste and abuse, or other utilization review, in large, multi-payer databases with diverse health care benefit structures and claim processing systems, including private plans (commercial insurance), Federal (Medicare), or State public plans (Medicaid).

• 5 years of experience researching, interpreting, and applying payer medical (coverage) policies (e.g., LCDs, NCDs, private carrier medical policies) and common industry claim edits (e.g., NCCI).

• Demonstrated expertise in the complete Microsoft Office Suite including Word, Excel, and PowerPoint (candidate may be called upon to show examples from portfolio or submit practicum assignments).

• US citizen or Permanent Resident

• Must be able to obtain/maintain Public Trust

DESIRED QUALIFICATIONS:

• Competence and experience in the following programming languages and platforms: Python and/or R (via JupyterHub), Snowflake, SQL, Linux, AWS.

• Competence and experience with the Atlassian Suite or similar software (Jira, Confluence, BitBucket, etc.)

• Experience with a GIT-based development workflow.

• Experience using Tableau or other data visualization software, with demonstrable experience communicating and visualizing complex healthcare analytic outcomes (candidate may be called upon to show examples from portfolio or submit practicum assignments).

• Ability to communicate technical outcomes with a high degree of detail and precision to technical audiences, while at the same time being able to communicate those outcomes to non-technical audiences in an approachable and understandable manner.

• Exceptional problem-solving abilities, accuracy with work, strong organizational skills, attention to detail and the ability to multi-task while meeting deadlines.

• Excellent communication skills, both written and verbal, and especially the ability to communicate data clearly to clients.

• Ability to work in a fast-paced, team-oriented environment with minimal supervision.

GDIT IS YOUR PLACE:
 

• 401K with company match. 

• Customizable health benefits packages. 

• Internal mobility team dedicated to helping you own your career. 

• Challenging work that makes a real impact on the world around you. 

• Full-flex work week. 

Salary : $85,600 - $128,400