Data Scientist - Medicaid

Peraton

$80K — $128K *
US-AnywhereRemote in United States
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 5+ years of experience with a BS/BA; 3+ years with an MS/MA; PhD candidates welcome with no prior experience
  • Ability to work with diverse systems and analytical tools
  • Experience in SQL, SAS, R, or Python for dataset construction
  • Proficiency in developing detection models using SAS, R, or Python
  • Demonstrated experience managing statistical modeling projects
  • U.S. citizenship required

Responsibilities

  • Analyze complex data to identify trends and patterns
  • Develop programming queries for data analysis
  • Present regulatory violations related to fraud
  • Conduct self-directed research on Medicare payment issues
  • Organize project development and research violations
  • Document programming efforts and project steps
  • Potential court appearances to testify on findings

Benefits

  • Telework options available for EST or CST regions
Full Job Description
Responsibilities

SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.

We are looking to add a Data Scientist to our SGS team of talented professionals.

 

What you'll do:

 

As a Data Scientist, you will analyze and interpret data using a range of techniques, from basic aggregation to advanced machine learning models. You will design, test, and implement fraud detection algorithms while leveraging advanced analytics to uncover sophisticated and large-scale fraud schemes. This role involves close collaboration with project teams and business leaders to define and address complex analytical needs. While you receive periodic supervision, you are expected to work independently, proactively seeking solutions to challenging problems.

 

  • Analyze complex data to identify and compare norms, trends and patterns.
  • Develop advanced programming queries to analyze complex data.
  • Present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government.
  • Conduct self-directed research to uncover problems in Medicare payments made to a variety of provider types including physicians, suppliers, hospital, rehabilitation facilities, Skilled Nursing Facilities, Rural Health Care Facilities, and other healthcare professionals as well as Home Health Agencies and Hospices
  • Organize and coordinate project development, research violations.
  • Accurately and thoroughly document all steps taken in programming efforts and project development.
  • This position may require the incumbent to appear in court to testify on work findings.
  • Telework available from EST or CST only.
Qualifications

Basic Qualifications:

  • 5 years with BS/BA; 3 years with MS/MA; 0 years with PhD
  • Proven Ability to work with a variety of systems, sources of data and analytical tools.
  • Experience in constructing datasets from data warehouses or centralized databases for analysis using SQL, SAS, R, or Python.
  • Experience in developing detection models using tools such as SAS, R, and/or Python.
  • Experience managing statistical modeling projects.
  • U.S. citizenship required
  • Telework available from EST or CST only.

 Desirable Qualifications:

The most competitive candidates will have:

  • Strong understanding of Statistical models that include, but not limited to regression, Survival analysis, and functional data analysis to build analyses that address business problems.
  • Strong understanding of machine language.
  • Strong computer skills that include experience in relational database design, extract, and reporting, Excel, and the Internet.
  • Strong proven analytical ability and basic knowledge of statistics and sampling techniques
  • Strong communication and organization skills 

 

Target Salary Range$80,000 - $128,000. This represents the typical salary range for this position. Salary is determined by various factors, including but not limited to, the scope and responsibilities of the position, the individual’s experience, education, knowledge, skills, and competencies, as well as geographic location and business and contract considerations. Depending on the position, employees may be eligible for overtime, shift differential, and a discretionary bonus in addition to base pay.

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