Role details

Contract type

Permanent contract

Employment type

Full-time (> 32 hours)

Experience level

Experienced

Experience required

2 years minimum

Compensation

$90,000.0 - $110,000.0

Working hours

Regular working hours

Job source

www.clearancejobs.com

Tech stack

Business Analytics Applications Health Informatics Fraud Prevention and Detection R (Programming Language) Python (Programming Language) SQL Databases Pyspark Information Technology Data Pipelines

Job description

• Develop, test, document, and maintain fraud, waste, and abuse (FWA) business rules, algorithms, and provider risk-scoring methodologies
• Analyze healthcare claims, enrollment, and exclusion data to identify anomalies, overpayments, fraud schemes, and prioritized investigative leads
• Support Palantir platform configuration, analytics development, data pipelines, integrations, and weekly analytic runs for War Room operations
• Build dashboards, visualizations, leadership reports, and fraud trend analyses to support governance and decision-making
• Perform rule back-testing, quality assurance reviews, precision measurement, documentation, and knowledge transfer activities for VA personnel

Requirements

• 2-5 years of experience in federal healthcare data analytics, healthcare fraud detection, payment integrity, Medicare, Medicaid, or VA healthcare data environments
• Strong proficiency with SQL, Python, PySpark, R, healthcare data analytics platforms, data pipelines, transformations, and dashboard development
• Experience working with healthcare claims data, CPT/HCPCS codes, ICD-10 coding, provider and beneficiary data, and handling sensitive PHI under HIPAA requirements
• Bachelor’s degree in Information Technology, Computer Science, Data Science, Statistics, Health Informatics, or a related field
• Ability to pass a Public Trust clearance (Tier 2 / Moderate Background Investigation) and obtain a VA PIV card

Benefits & conditions

• Salary Range: $90,000 - $110,000 annually depending on experience
• Full Benefits Package: PTO, Paid Holidays, Medical, Dental, Vision, 401K, Tuition Reimbursement, Sick Leave as required by law

Apply for this position

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