What You Will Do - Essential FunctionsThe Senior Data Analyst reports to the Director of Program Integrity and plays a key role in supporting the organization's Fraud, Waste, and Abuse (FWA) program. This position is responsible for developing reports, conducting advanced data analysis, and monitoring key indicators to ensure adherence to regulatory standards and internal compliance requirements. The role works collaboratively across multiple departments to drive compliance initiatives, enhance data integrity, and improve overall operational efficiency.
- Fraud, Waste & Abuse Detection
- Develop proactive analytics and use advanced data analysis, pattern recognition, and anomaly detection to identify potential FWA activity.
- Analyze complex datasets to uncover trends, compliance risks, and operational issues requiring corrective action.
- Reporting, Insights & Stakeholder Support
- Create and maintain reports, dashboards, and visualizations to communicate insights across the organization.
- Support investigators and internal initiatives with data analysis, reporting, case development, and presentations.
- Operations, Systems & Performance Tracking
- Manage case management systems, ensuring data accuracy, workflow efficiency, and timely updates.
- Track departmental metrics (e.g., case volumes, outcomes, performance) and support operational needs, including travel and additional duties.
Who You Are- Required Qualifications
- Bachelor's degree or higher in business administration, statistics, computer science, health care administration or related field
- 5+ years experience in data analytics, compliance, program integrity, SIU, or fraud/waste/abuse analytics.
- 5+ years experience working in Business Objects, SAS, SQL and/or other data analytics programs and applications
- Familiarity with data modeling languages
- Strong understanding of FWA concepts, regulatory requirements, and compliance frameworks (e.g., CMS, Medicaid/Medicare, OIG).
- Experience supporting investigations, audits, or case development.
- Strong communication skills with the ability to present findings to technical and non-technical audiences.
- Experience working with Microsoft 365 suite of programs
- Ability to pass background check upon hire and throughout employment to include criminal felony & misdemeanor search, SSN validation/trace search (LEIE), education report (highest degree obtained), civil upper and lower search, 7-year employment report, federal criminal search, statewide criminal search, widescreen plus national criminal search, health care sanctions-state med (SAM), national sex offender registry, prohibited parties (OFAC) (terrorist watchlist), and a 10-Panel Drug Screen.
- Someone who embodies our values by:
- Serving everyone with compassion and leading with empathy.
- Stepping up and creating value by taking charge and acting when there is an opportunity.
- Adapting in a changing world by recognizing our responsibility to be agile and respond quickly.
- Nurturing growth and belonging by respecting and celebrating everyone for who they are.
- Competencies
- Responsible with a high level of integrity and ethical standards
- Intuitive nature to identify compliance irregularities
- Excellent communication and interpersonal skills, with the ability to collaborate across teams.
- Working Conditions:
- High-speed internet service (cable or fiber optic) with minimum download Speed of 20 Mbps, Upload Speed of 5 Mbps, and Maximum Latency of 100 milliseconds (must be installed before starting) required.
- Frequent use of computer and phone systems
- Must be able to constantly remain in a stationary, sitting position, communicate and exchange information with others, inspect information, perform repetitive motions with arms and fingers, interpret data, problem solve, make decisions, organize and plan, and maintain a positive and professional attitude in all situations.
- Work is performed from home with company-provided equipment. Sitting for long periods of time is expected and use of fingers and hands for typing is necessary.
- A quiet workspace with minimal background noise for calls.
- For roles requiring travel, employees must be able to travel by air to various locations and stay overnight in hotels as needed for business purposes which includes ability to manage travel logistics, adapt to varying time zones and environments, and adapt to varying worksite conditions.
We encourage applicants from a variety of backgrounds and experiences to apply, especially those who can demonstrate how their unique qualifications and skills align with the requirements of this role and support our mission to improve whole-person health.
This position will accept and review new applications and resumes no less than 5 business days after the original posting date and may remain open an extended period of time with no set end date based on the level of interest.
